Pioneering cardiac surgeon Johannes Bonatti, MD

Robotic-assisted cardiac surgery is the latest example of the expanded heart and vascular care and advanced technology now available at UPMC Passavant.

So, when Ross Township resident Jack Schrass learned he needed surgery at age 69 to repair a leaky heart valve, he didn’t have far to go to receive top-notch care.

Jack was diagnosed in 2001 with mitral valve prolapse. He began seeing UPMC cardiologist Bradley Heppner, MD, 10 years ago for yearly checkups and electrocardiograms.

Your heart’s mitral valve is located between the left ventricle and the left atrium, or the upper and lower chambers of the heart. It operates like a one-way gate to stop blood from flowing the wrong way.

With mitral valve prolapse, the valve doesn’t close right. That can cause blood to leak back into the atrium — a condition called mitral valve regurgitation. In severe cases, it can lead to congestive heart failure.

By 2021, an increasing amount of blood was leaking back into Jack’s left atrium.

“I had no symptoms, but I had significant backflow of blood,” Jack says. “My heart wasn’t working as efficiently as it could.”

A Groundbreaking Surgeon

Pioneering cardiac surgeon Johannes Bonatti, MD, with the robotic system utilized for minimally invasive mitral valve repair at UPMC Passavant–McCandless.

Jack’s cardiologist referred him to cardiac surgeon Johannes Bonatti, MD, director of cardiac robotic surgery, UPMC Heart and Vascular Institute. Before going to his first appointment, Jack did some research — and was impressed.

“I found out Dr. Bonatti is a pretty big deal,” he says. “I was happy to have a doctor with his credentials and background doing my surgery.”

Dr. Bonatti, who joined UPMC in May 2021, is an internationally recognized expert and pioneer in the use of robotic-assisted cardiothoracic surgery. He has performed more than 5,000 cardiac surgeries, including the world’s first robotic endoscopic quadruple coronary bypass procedure. He performs robotic surgery at UPMC Presbyterian and UPMC Passavant–McCandless.

Jack remembered when his father had open heart surgery and the long, painful recovery he endured. When the retired systems engineer met with Dr. Bonatti, he was delighted to learn his leaky valve could be fixed without opening his chest — and with the help of a robot.

“I was happy to have him do it robotically,” Jack says. “I have a high comfort level with technology, and I think robotics is the way of the future.”

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A Minimally Invasive Procedure

At UPMC, cardiac surgeons prefer to use minimally invasive approaches when possible because patients generally have:

  • Reduced risk of infection.
  • A shorter hospital stay.
  • An overall faster recovery.

The robotic system is an advanced approach to minimally invasive mitral valve repair. It is a cutting-edge surgical tool that provides greater accuracy and visualization of the heart.

“Mitral valve repair is very delicate work,” Dr. Bonatti says. “Robotic surgery allows us to do these procedures without opening the chest. I can use mini incisions with a precision that is impossible without the robot.”

Unlike open heart surgery, where surgeons cut open the chest and breastbone to access the heart and make repairs, the robotic procedure is performed with several very small incisions on the side of the chest. Another small incision in the groin is used to connect the patient to a heart-lung machine. This machine keeps blood flowing while the heart is stopped during surgery.

A tiny camera and specially designed surgical instruments are inserted through the ports and a mini-thoracotomy (an incision between the ribs) in the chest. They are attached to robotic arms controlled by the surgeon from a nearby console. The camera enables the surgeon to see inside the chest and heart with a 3D, high-definition view that can be magnified up to 10 times.

During the procedure, Dr. Bonatti controls the system’s robotic arms from a nearby console.

“The robot provides better vision and dexterity,” Dr. Bonatti says. “You can work in very small spaces inside the body, move and turn around, and do difficult surgical maneuvers.”

Before having surgery, Jack had blood tests and a heart catheterization procedure done at UPMC Passavant–McCandless. He returned to the hospital for surgery on Sept. 21, 2021.

Back on the Move

The day after his operation, Jack was up walking around the intensive care unit. He went home just three days after surgery.

“I was amazed how well it turned out,” Jack says. “I really didn’t have any pain. I felt very good emotionally and physically.”

An energetic grandfather of eight, Jack plays tennis year-round, bikes regularly, and enjoys yard work. He was eager to return to his active lifestyle, but he gladly went through three weeks of cardiac rehab at UPMC Passavant­–Cranberry to make sure he was ready.

“I was very pleased with the care provided,” Jack says. “I wore a monitor that kept track of my heartbeat while working on the exercise bike or treadmill. It was reassuring when they told me, ‘Your heartbeat looks good.'”

Johannes Bonatti, MD, a cardiac surgeon and director of cardiac robotic surgery at UPMC Heart and Vascular Institute, with Ross Township resident Jack Schrass, one of the first patients to undergo robotic mitral valve repair surgery at UPMC Passavant–McCandless.

Jack, now 70, was doing yard work in October and playing tennis again in November.

“I’m doing all the things I was doing before. I’m really happy with the way everything turned out,” he says.

“Dr. Bonatti clearly is a very skilled surgeon. All the incisions healed so quickly and cleanly. We’re lucky to have him here at UPMC Passavant.”

Specialized Cardiac Care, Close to Home

The availability of expanded cardiovascular care and advanced technology at UPMC Passavant makes it more convenient for patients in Pittsburgh’s northern suburbs and beyond to get world-class care.

“Being able to go to UPMC Passavant just minutes from home was convenient for me and my wife,” Jack says. “She stayed with me at the hospital into the evening a couple times. I know she was a lot more comfortable having just a short drive home.”

Over the past 20 years, UPMC Passavant has grown from providing essential cardiac care to a regional center for advanced heart care and services. A multidisciplinary team of experts uses the latest technology, cutting-edge research, and clinical trials to give patients access to the best possible treatment.

“UPMC Passavant really has developed into a full-service hospital,” Jack says. “I was very happy I could have the surgery done there — and by a pioneering doctor.”

Whether it’s near your home or office, you can find expert cardiac care at UPMC Passavant and throughout the northern communities of Pittsburgh. To find a provider near you, visit our website.

About Heart and Vascular Institute

The UPMC Heart and Vascular Institute has long been a leader in cardiovascular care, with a rich history in clinical research and innovation. As one of the first heart transplant centers in the country and as the developer of one of the first heart-assist devices, UPMC has contributed to advancing the field of cardiovascular medicine. We strive to provide the most advanced, cutting-edge care for our patients, treating both common and complex conditions. We also offer services that seek to improve the health of our communities, including heart screenings, free clinics, and heart health education. Find an expert near you.