Hybrid robotic off‐pump versus conventional on‐pump and off‐pump coronary artery bypass graft surgery in women

Torregrossa, Gianluca; Sá, Michel Pompeu Barros de Oliveira; Eynde, Jef Van den; Malin, John H.; Sicouri, Serge; Wertan, MaryAnn C.; Ramlawi, Basel; Sutter, Francis P.

doi:10.1111/jocs.16247

Cited by 11 publications

(8 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, contrarily to the widespread belief, hybrid procedures with stents did not yield worse results over time in comparison with the nonhybrid group (likely owing to the evolution of drug‐eluting stents). We demonstrated in previous studies that patients treated surgically for coronary disease can be equally treated with LIMA to LAD plus saphenous vein grafts or stents for non‐LAD vessels with similar long‐term outcomes, 27–29 suggesting that contemporary stents can be as effective as other grafts to treat non‐LAD lesions. There is an interesting aspect in our study which we should highlight.…”

Section: Discussionmentioning

confidence: 80%

Robotic‐assisted versus conventional off‐pump coronary surgery in women: A propensity‐matched study

Torregrossa

Sá

Eynde

et al. 2022

Journal of Cardiac Surgery

Self Cite

View full text Add to dashboard Cite

Background: Off-pump coronary artery bypass (OPCAB) previously demonstrated its potential benefits in women; however, robotic-assisted OPCAB was scarcely studied.Objectives: To investigate whether robotic-assisted OPCAB could further improve the outcomes in women and the potential impact of hybrid approaches with stents and completeness of revascularization on the late outcomes. Methods: Women who underwent robotic-assisted or conventional OPCAB (with sternotomy) between May 2005 and January 2021 at Lankenau Heart Institute were included. Propensity score matching was used to match 273 pairs on 27 characteristics.Results: In the intraoperative period, women who underwent robotic-assisted OPCAB presented longer operative times (6.00 vs. 5.38 h; p < 0.001), higher rates of extubation in the operating room (83.9% vs. 75.5%; p = 0.019) and lower rates of blood transfusion (13.2% vs. 32.2%; p < 0.001). In the postoperative period, women who underwent robotic-assisted OPCAB presented lower rates of new onset atrial fibrillation (16.8% vs. 25.6%; p = 0.016), need of blood transfusion (33.0% vs. 54.9%; p < 0.001), shorter intensive care unit (ICU) (46.1 vs. 49.8 h; p = 0.006) and hospital length of stay (5.0 vs. 6.0 days; p < 0.001). We observed no statistically significant differences in the rates of operative death between the groups (1.47% vs. 1.47%; p = 0.771). In the follow-up, we observed no differences in terms of overall survival regardless of hybrid procedures with stents and completeness of revascularization.Conclusions: Robotic-assisted OPCAB in women is as safe as conventional OPCAB and may further improve outcomes. Hybrid coronary revascularization was a valuable adjunct in the robotic scenario and completeness of revascularization did not play a role in this setting.

show abstract

Section: Discussionmentioning

confidence: 80%

Robotic‐assisted versus conventional off‐pump coronary surgery in women: A propensity‐matched study

Torregrossa

Sá

Eynde

et al. 2022

Journal of Cardiac Surgery

Self Cite

View full text Add to dashboard Cite

show abstract

“…24 Recently, there is growing interest in hybrid coronary revascularisation procedures combining LIMA graft to the LAD with PCI for lesions in other epicardial vessels. 25 Given the limited patency of saphenous vein grafts, 26 this hybrid revascularisation strategy may be an important treatment option especially in patients with MVD, including a P-LAD lesion. Although this is beyond the scope of the current study, further studies are warranted to address this.…”

Section: Coronary Artery Diseasementioning

confidence: 99%

Mortality after multivessel revascularisation involving the proximal left anterior descending artery

Ono

Hara

Gao

et al. 2022

Heart

View full text Add to dashboard Cite

ObjectiveWe sought to investigate whether long-term clinical outcomes differ following percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) in patients with three-vessel disease (3VD) and lesions in the proximal left anterior descending artery (P-LAD).MethodsThis post-hoc analysis of the Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) Extended Survival study included patients with 3VD who were classified according to the presence or absence of lesions located in the P-LAD. Ten-year all-cause death and 5-year major adverse cardiac or cerebrovascular events (MACCE) were assessed.ResultsAmong 1088 patients with 3VD, 559 (51.4%) had involvement of P-LAD and their 10-year mortality was numerically higher following PCI versus CABG (28.9% vs 21.9%; HR: 1.39, 95% CI 0.99 to 1.95). Although patients without P-LAD lesions had significantly higher 10-year mortality following PCI compared with CABG, there was no evidence of a treatment-by-subgroup interaction (28.8% vs 20.2%; HR: 1.47, 95% CI 1.03 to 2.09, pinteraction=0.837). The incidence of MACCE at 5 years was significantly higher with PCI than CABG, irrespective of involvement of P-LAD (with P-LAD: HR: 1.86, 95% CI 1.36 to 2.55; without P-LAD: HR: 1.54, 95% CI 1.11 to 2.12; pinteraction=0.408). Individualised assessment using the SYNTAX Score II 2020 established that a quarter of patients with P-LAD lesions had significantly higher mortality with PCI than CABG, whereas in the remaining three-quarters CABG had similar mortality.ConclusionsAmong patients with 3VD, the presence or absence of a P-LAD lesion was not associated with any treatment effect on long-term outcomes following PCI or CABG.Trial registration numberSYNTAXES:NCT03417050; SYNTAX:NCT00114972.

show abstract

“…Despite not routinely adopted, robotic coronary artery surgery is an established procedure for the management of coronary artery disease (CAD). In the current practice of ageing population, technical improvements of stents deployment and excellent results of guideline directed optimal medical therapy, an increase patient population with moderate CAD could be treated with robotic coronary artery bypass grafting (CABG) alone or in combination with stents (hybrid procedure) to widespread the benefit of the left internal thoracic artery (LITA) to the left anterior descending artery (LAD) rather than receiving multivessels percutaneous coronary intervention (PCI) (1,2). The number of robotic coronary surgery programs around North America has seen a steady growth (3) due to the benefits of the procedure ranging from small incision to fast postoperative recovery.…”

Section: Introductionmentioning

confidence: 99%

Establishing a robotic coronary artery bypass surgery program: a narrative review

Torregrossa¹,

Dokollari²,

Sá³

et al. 2023

J Vis Surg

View full text Add to dashboard Cite

Background and Objective: Robotic coronary artery bypass surgery is an established procedure for treatment of coronary artery disease. The goal of this manuscript is to provide an overview on how to build a successful robotic coronary artery bypass grafting (CABG) surgery program and analyze its learning curve.Methods: We performed a narrative review of the current medical literature comparing the robotic CABG survival rate. English literature published by January 30 th , 2021 were searched in PubMed/MEDLINE, Embase, SciELO, LILACS, CCTR/CENTRAL and Google Scholar.

show abstract

Hybrid robotic off‐pump versus conventional on‐pump and off‐pump coronary artery bypass graft surgery in women

Cited by 11 publications

References 35 publications

Robotic‐assisted versus conventional off‐pump coronary surgery in women: A propensity‐matched study

Robotic‐assisted versus conventional off‐pump coronary surgery in women: A propensity‐matched study

Mortality after multivessel revascularisation involving the proximal left anterior descending artery

Establishing a robotic coronary artery bypass surgery program: a narrative review

Contact Info

Product

Resources

About