Robotic‐assisted coronary artery bypass surgery: an 18‐year single‐centre experience

Giambruno, Vincenzo; Chu, Michael; Fox, Stephanie A.; Swinamer, Stuart A.; Rayman, Reiza; Markova, Zarina; Barnfield, Rebecca; Cooper, Mitchell; Boyd, Douglas; Menkis, Alan H.; Kiaii, Bob

doi:10.1002/rcs.1891

Cited by 29 publications

(29 citation statements)

References 19 publications

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“…Postoperative angiogram was performed in 599 patients with early graft patency of 97.4%. 6 In the early 2000s, hybrid coronary revascularization, which combines surgical LIMA-LAD bypass with PCI, emerged as an alternative treatment option for multivessel coronary artery disease. In the hybrid procedure, the surgical graft could be routinely evaluated at the time of PCI.…”

Section: Early Graft Patency After Rmidcabmentioning

confidence: 99%

Graft Patency after Robotically Assisted Coronary Artery Bypass Surgery

Kuwabara

Nisivaco

Balkhy

2019

Innovations�(Phila)

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Objective With advances in robotic instrumentation and technology, both robotically assisted minimally invasive direct coronary artery bypass (RMIDCAB) and totally endoscopic coronary artery bypass (TECAB) have been widely used over the past 20 years. Graft patency is the most important outcome in coronary bypass surgery and is associated with long-term prognosis. In this article we reviewed all experts’ studies in the field of robotic assisted coronary artery bypass and investigated graft patency in patients who underwent RMIDCAB or TECAB. Methods We performed a literature search in PubMed from 1999 to 2018 using the terms “Robotic” and “Coronary bypass” and/or “Minimally invasive” and/or “Totally endoscopic.” Of the articles found, studies investigating graft patency were specifically selected. Results In 33 articles, a total of 4,000 patients underwent robotic assisted coronary artery bypass surgery either by a RMIDCAB (2,396) or by a TECAB (1,604) approach. The graft patency was assessed by invasive angiography or computed tomographic angiography in all studies. The mean graft patency at early (<1 month), midterm (<5 years), and long-term (>5 years) follow-up was 97.7%, 96.1%, and 93.2% in RMIDCAB and 98.8%, 95.8%, and 93.6% in TECAB, respectively. Conclusions The graft patency of robotic assisted coronary artery bypass was equivalent to reported outcomes of the conventional approach. These results should encourage the adoption of robotic approaches in coronary bypass surgery.

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Section: Early Graft Patency After Rmidcabmentioning

confidence: 99%

Graft Patency after Robotically Assisted Coronary Artery Bypass Surgery

Kuwabara

Nisivaco

Balkhy

2019

Innovations�(Phila)

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“…The benefits of robotic cardiac surgery have been established and amply described . Robotic cardiac surgery allows for excellent visualization of intra and epicardial structures.…”

Section: Discussionmentioning

confidence: 99%

Robotic totally endoscopic excision of aortic valve papillary fibroelastoma: The least invasive approach

2019

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Introduction: Papillary fibroelastomas (PFEs) are a rare subtype of benign primary cardiac tumors, which are most commonly found on the aortic valve (AV). They have the potential to cause severe adverse clinical consequences, thus prompting surgical excision in the majority of cases. In this article, we report on a series of 5 PFEs resected from the AV using a robotic-assisted sternal-sparing approach, and review of the literature on this approach. To our knowledge, this is the largest reported series of robotic-assisted sternal-sparing AV-PFE resections.Materials and Methods: From May 2016 until November 2018, 5 patients at our institution underwent removal of a papillary fibroelastoma from the aortic valve using a totally endoscopic robotic-assisted approach. After obtaining institutional IRB approval, we retrospectively reviewed their data for this report. We additionally contacted the patients to acquire a last clinical follow up for this study. Results In this series of 5 patients who underwent robotic totally endoscopic excision of AV PFE, all patients had successful removal of their tumor with no significant morbidity or mortality. All 5 patients were seen at a 30-day follow-up office visit, at which time they had recovered from surgery and were back to full activity. At a mean of 24 months all patients were doing well and free of symptoms with no evidence of tumor recurrence on repeat echo evaluation.Discussion: This is a series of 5 patients with AV-associated PFEs who underwent robotic totally-endoscopic excision without rib-spreading or conversion to sternotomy. This report demonstrated the successful application of robotic-assisted technology in aortic valve pathology. All PFEs were successfully removed without valve repair or replacement. We were able to offer a safe, curative, minimally-invasive surgical excision option for this group of patients. Conclusion:Our patients in this cohort demonstrated the well-established benefits of robotic sternal-sparing cardiac surgery, including excellent intra and postoperative outcomes and accelerated recovery. K E Y W O R D S cardiac fibroelastoma, robotic, valve repair/replacement

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“…82 This low prevalence is largely owing to the absence of large randomized control trials demonstrating its long-term safety or superiority over conventional CABG, although trials have suggested its safety and cost-effectiveness. 84,85 Further barriers to the dissemination of robotic technology in this setting include the initial high equipment cost, a significant learning curve and a relatively longer operating time. 82,83 A recent trial evaluated a single-center experience of robotic coronary artery bypass grafting over 18 years (1998-2016).…”

Section: Robotic Coronary Artery Bypass Graftingmentioning

confidence: 99%

“…82,83 A recent trial evaluated a single-center experience of robotic coronary artery bypass grafting over 18 years (1998-2016). 84 The cohort size was 605 with a reported operative mortality of 0.3%. The learning curve is reflected in the observation that after the first 200 cases, the conversion rate to sternotomy fell from 16% to 6.9%.…”

Section: Robotic Coronary Artery Bypass Graftingmentioning

confidence: 99%

“…The mean duration of stay in the intensive care unit and hospital were 1.2 § 1.4 and 4.8 § 2.9 days, respectively. 84 The risks of renal replacement therapy and prolonged mechanical ventilation were 0.2% and 0.8%, respectively. 84 Despite the learning curve and the lack of a control group, the investigators have demonstrated that robotic-assisted coronary artery bypass is safe and feasible in selected patients.…”

Section: Robotic Coronary Artery Bypass Graftingmentioning

confidence: 99%

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The Year in Cardiothoracic and Vascular Anesthesia: Selected Highlights from 2019

Evans¹,

Weiner

Shaefi

et al. 2020

Journal of Cardiothoracic and Vascular Anesthesia

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This highlights in our specialty for 2019 begin with the ongoing major developments in transcatheter valve interventions. Thereafter, the advances in left ventricular assist devices are reviewed. The recent focus on conduit selection and robotic options in coronary artery bypass surgery are then explored. Finally, this special articles closes with a discussion of pulmonary hypertension in noncardiac surgery, anesthetic technique in cardiac surgery, as well as postoperative pneumonia and its outcome consequences.

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Robotic‐assisted coronary artery bypass surgery: an 18‐year single‐centre experience

Abstract: Robot-assisted coronary artery bypass grafting is safe, feasible and it seems to represent an effective alternative to traditional coronary artery bypass grafting in selected patients.

Cited by 29 publications

References 19 publications

Graft Patency after Robotically Assisted Coronary Artery Bypass Surgery

Graft Patency after Robotically Assisted Coronary Artery Bypass Surgery

Robotic totally endoscopic excision of aortic valve papillary fibroelastoma: The least invasive approach

The Year in Cardiothoracic and Vascular Anesthesia: Selected Highlights from 2019

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