Early clinical and angiographic outcomes after robotic-assisted coronary artery bypass surgery

Halkos, Michael E.; Liberman, Henry; Devireddy, Chandan; Walker, Patrick F.; Finn, Aloke V.; Jaber, Wissam; Guyton, Robert A.; Puskas, John D.

doi:10.1016/j.jtcvs.2013.09.010

Cited by 91 publications

(74 citation statements)

References 19 publications

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“…After exclusion of duplicated studies and 546 irrelevant articles based on abstracts and titles, 126 studies remained for full-text evaluation. Of these, 44 studies met the inclusion criteria, including nine studies in the TECAB off-pump group (10)(11)(12)(13)(14)(15)(16)(17)(18); two studies in the TECAB on-pump group (19,20); and 16 studies in the robotic MIDCAB group (10,(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33). One study provided separate data for both the TECAB offpump and robotic MIDCAB groups, and was included for analysis in both groups (10).…”

Section: Resultsmentioning

confidence: 99%

A systematic review on robotic coronary artery bypass graft surgery

Cao

Indraratna

Doyle

et al. 2016

Ann. Cardiothorac. Surg.

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Background: Robotic-assisted coronary artery bypass graft surgery (CABG) has been performed over the past decade. Despite encouraging results from selected centres, there is a paucity of robust clinical data to establish its clinical safety and efficacy. The present systematic review aimed to identify all relevant clinical data on robotic CABG. The primary endpoint was perioperative mortality, and secondary endpoints included perioperative morbidities, anastomotic complications, and long-term survival.Methods: Electronic searches were performed using three online databases from their dates of inception to 2016. Relevant studies fulfilling the predefined search criteria were categorized according to surgical techniques as (I) totally endoscopic coronary artery bypass without cardiopulmonary bypass (TECAB offpump); (II) TECAB on-pump; and robotic-assisted mammary artery harvesting followed by minimally invasive direct coronary artery bypass (robotic MIDCAB).Results: The present systematic review identified 44 studies that fulfilled the study selection criteria, including nine studies in the TECAB off-pump group and 16 studies in the robotic MIDCAB group.Statistical analysis reported a pooled mortality of 1.7% for the TECAB off-pump group and 1.0% for the robotic MIDCAB group. Intraoperative details such as the number and location of grafts performed, operative times and conversion rates, as well as postoperative secondary endpoints such as morbidities, anastomotic complications and long-term outcomes were also summarized for both techniques.Conclusions: A number of technical, logistic and cost-related issues continue to hinder the popularization of the robotic CABG procedure. Current clinical evidence is limited by a lack of randomized controlled trials, heterogeneous definition of techniques and complications, as well as a lack of robust clinical followup with routine angiography. Nonetheless, the present systematic review reported acceptable perioperative mortality rates for selected patients at specialized centres. These results should be considered as a useful benchmark for future studies, until further data is reported in the form of randomized trials.

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Section: Resultsmentioning

confidence: 99%

A systematic review on robotic coronary artery bypass graft surgery

Cao

Indraratna

Doyle

et al. 2016

Ann. Cardiothorac. Surg.

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“…Recent long-term follow-up studies [8,9] showed an equivalent result in terms of mortality, major adverse cardiovascular events, and need for revascularization between robotic and conventional CABG. More encouragingly, robotic CABG is likely to reduce postoperative complications in patients with single-vessel disease [18].…”

Section: Commentmentioning

confidence: 99%

“…Both left and right internal mammary arteries (IMAs) could be harvested on the same side of a patient [7]. Recent reports showed that robotic CABG had comparable short-term results to conventional CABG and a lower reintervention rate compared with percutaneous coronary intervention (PCI) [8,9]. However, report on the longterm outcome and the graft patency after robotic CABG was limited [10].…”

mentioning

confidence: 99%

Robotic Total Arterial Off-Pump Coronary Artery Bypass Grafting: Seven-Year Single-Center Experience and Long-Term Follow-Up of Graft Patency

Yang

Wang

et al. 2015

The Annals of Thoracic Surgery

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“…The LIMA is then harvested according to surgeon preference, either in a skeletonized or pedicled fashion. Next, a thoracotomy is made directly over the LAD, through which the anastomosis is carried out similar to the MIDCAB procedure (robotic assisted) (9). An alternative is total endoscopic coronary artery bypass (TECAB).…”

Section: Interventionsmentioning

confidence: 99%

Hybrid coronary revascularization for the treatment of multivessel coronary artery disease

Kayatta

Halkos

Puskas³

2018

Ann. Cardiothorac. Surg.

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Coronary artery disease (CAD) has typically been treated either medically, with percutaneous coronary intervention (PCI), or with coronary artery bypass grafting (CABG). As advances in stent technology and minimally invasive surgery have developed, a third option has emerged: hybrid coronary revascularization (HCR). In HCR, minimally invasive CABG and PCI are both employed to treat a single patient, often during the same hospital stay. Patients appropriate for this technique vary widely, from low-risk patients with low SYNTAX lesions outside the left anterior descending artery (LAD), to high-risk patients with multiple comorbidities who are felt by the heart team to benefit most by avoiding a sternotomy. Across both our experience and other series in the literature, mortality with HCR is around 1%. Hospital length of stay is less than one week, and typically less than after conventional CABG, but longer than with isolated PCI. Return to baseline activity is substantially shorter after minimally invasive CABG compared to conventional CABG due to the avoidance of a sternotomy; deep sternal wound infections are entirely avoided. Mid-term need for repeat revascularization may be higher with HCR, though randomized data are lacking. In conclusion, HCR is an evolving method to treat multivessel CAD with favorable early results in high volume centers, though growth in the field is limited by surgical experience and success with minimally invasive techniques.

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Early clinical and angiographic outcomes after robotic-assisted coronary artery bypass surgery

Abstract: Robotic-assisted coronary artery bypass grafting is an effective alternative to traditional coronary artery bypass grafting for patients with single or multivessel coronary artery disease, with comparable short-term clinical and angiographic results.

Cited by 91 publications

References 19 publications

A systematic review on robotic coronary artery bypass graft surgery

A systematic review on robotic coronary artery bypass graft surgery

Robotic Total Arterial Off-Pump Coronary Artery Bypass Grafting: Seven-Year Single-Center Experience and Long-Term Follow-Up of Graft Patency

Hybrid coronary revascularization for the treatment of multivessel coronary artery disease

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