Quality of Life Improvement after Robotically Assisted Coronary Artery Bypass Grafting

Abstract

Objectives: Coronary artery bypass grafting (CABG) is associated with long rehabilitation periods and slow quality of life (QOL) improvement. Totally endoscopic coronary artery bypass grafting (TECAB) can be performed using robotic technology and remote access perfusion. The aim of this study was to evaluate whether TECAB leads to accelerated QOL improvement as compared to standard CABG. Methods: We included 120 patients who had received robotically assisted CABG, 56 of whom were operated on using standard sternotomy. These patients were compared to 55 patients who underwent the TECAB procedure and to 9 TECAB patients who required conversion to conventional sternotomy. QOL evaluation was performed before the operation and 1, 3 and 6 months after the procedure using the SF-36 health survey and a standardized questionnaire. Results: All quality of life aspects improved significantly in all study patients. At 3 months, TECAB patients showed significantly better QOL scores related to bodily pain and physical health. Hospital stay and time to restoration of daily activities were significantly shorter. Converted patients experienced similar courses to sternotomy patients in terms of QOL. Conclusions: TECAB using robotic technology leads to improved physical health, shorter hospital stay and a more rapid restoration of daily activities. Conversion from TECAB to sternotomy does not lead to QOL impairment as compared to primary sternotomy.

Anesthetic considerations in robotic mitral valve surgery

“…The practice of robot-assisted mitral valve repair (MVR) offers numerous potential benefits to patients including shorter hospital length of stay (1)(2)(3), reduced postoperative pain (4), a lower rate of surgical site infection (4), diminished incidence of blood product transfusion (5,6), a faster return to normal daily activities (5,7), and greater overall patient satisfaction (4). Anesthesiologists play in a key role in facilitating optimal outcomes after robotic MVR.…”

History and Current Status of Robotic Totally Endoscopic Coronary Artery Bypass

“…Patients converted to sternotomy experienced similar courses to standard sternotomy patients in terms of QOL. 21 Srivastava et al reported in 2009 on 214 patients in Odessa, Texas, who underwent successful beating-heart TECAB from July 2004 to June 2007. Single-, double-, and triple-vessel beating-heart TECAB was performed in 139, 68, and 7 patients, respectively; 50 patients underwent a planned hybrid revascularization and 80% of patients (172 of 214) underwent computed tomography angiography (CTA) or conventional angiography within 3 months of surgery.…”

Robotically Assisted Totally Endoscopic Coronary Bypass Surgery

“…For patients after sternotomy off-pump CABG, this time was 4.4 months. Bonaros et al 42 compared Short Form-36 scores for patients after AHTECAB versus patients after conversion to sternotomy and primary sternotomy. At 1 month postoperatively, scores for general health were higher after TECAB.…”