Robotic totally endoscopic coronary artery bypass grafting (TECAB)—placement of bilateral internal mammary arteries to the left ventricle

Bonatti, Johannes; Vento, Antti; Bonaros, Nikolaos; Traina, Mahmoud; Lehr, Eric J.

doi:10.21037/acs.2016.11.05

Cited by 6 publications

(4 citation statements)

References 6 publications

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“…The current paradigm shift towards less invasive coronary interventions are paralleled by innovative MISCAR procedural and technological advances that comply with traditional CABG principles, graft patency, clinical outcomes and patient satisfaction (63)(64)(65)(66)(67)(68)(69)(70)(71)(72)(73)(74)(75)(76)(77)(78)(79)(80). Various institutions and collaborative reports now describe innovative variations in robotic-and non-robotic MISCAR techniques, with reports that outline risk reduction strategies for safe implementation of MISCAR programs also emerging (115)(116)(117)(118)(119)(120)(121).…”

Section: New Developments In Minimally Invasive Surgical Coronary Art...mentioning

confidence: 99%

Minimally invasive surgical coronary artery revascularization—current status and future perspectives in an era of interventional advances

Merwe¹,

Casselman²

2023

J Vis Surg

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We are currently witnessing rapid advances in coronary artery disease (CAD) diagnostic-and treatment technology, which include exciting developments in the utilisation of artificial intelligence, stem cell and genetic therapy and pharmacological innovation that complement contemporary transcatheter interventions (PCI) and patient preference for less invasive interventions. Progressive expansion of international CAD treatment guidelines with subsequent changes in referral patterns that favour less invasive interventions, increased patient expectations, industry driven marketing and an increasingly aging population with significant procedural risks, continue to re-define the role of conventional coronary artery bypass surgery by sternotomy access (CABG) in the treatment of CAD. However, the undisputed benefits of CABG over PCI in various clinical scenarios were recently re-confirmed and subsequently resulted in renewed interest in the development and application of less invasive surgical revascularization procedures. Reports by experienced minimally invasive surgical coronary artery revascularization (MISCAR) centres suggest shortand long-term outcomes that are comparable with conventional CABG and created an exciting platform for further MISCAR innovation while contributing to the global initiation of exciting upcoming MISCAR programs. This manuscript outlines the feasibility, current status and preliminary data of recent advances in contemporary CAD diagnostic-and therapeutic technology, provides and overview of the contemporary CAD revascularization decision-making evidence and describe the future perspectives of MISCAR in an era of rapid advances in less invasive CAD prevention-, diagnostic-and therapeutic technology. We trust that this overview will contribute to future research and changes in clinical practice.

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Section: New Developments In Minimally Invasive Surgical Coronary Art...mentioning

confidence: 99%

Minimally invasive surgical coronary artery revascularization—current status and future perspectives in an era of interventional advances

Merwe¹,

Casselman²

2023

J Vis Surg

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“…Однако в настоящее время наметилась тенденция к росту числа операций робот-ассистированного множественного коронарного шунтирования без ИК [19,79]. Следует отметить, что TECAB может быть как самостоятельным методом хирургического лечения, так и компонентом HCR, тем самым усиливая его миниинвазивный характер [26,40,74].…”

Section: ишемическая болезнь сердца Coronary Artery Diseaseunclassified

Minimally invasive coronary artery bypass surgery

Жбанов¹,

Kiladze²,

Uryuzhnikov³

et al. 2019

Kardiol. serdechno-sosud. khir.

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Представлен подробный обзор истории развития техники коронарного шунтирования вплоть до самых современных методик. Сравнивается коронарное шунтирование (КШ) с искусственным кровообращением (ИК) и без него (OPCAB) через срединную стернотомию. Оцениваются преимущества OPCAB перед традиционным КШ с ИК у пациентов с мультифокальным атеросклерозом, хронической обструктивной болезнью легких, хронической болезнью почек и другими тяжелыми сопутствующими заболеваниями. Проведен анализ результатов оригинальных исследований по этой проблеме. Описаны критерии выбора вида доступа (срединная стернотомия или левосторонняя мини-торакотомия) при КШ. Оценены роль, преимущества и эффективность гибридных технологий. Подробно описана история развития миниинвазивных технологий КШ, таких как MIDCAB и MICS CABG. Проанализированы преимущества, сложности и перспективы данных технологий, варианты их выполнения. Приведены доказательства, указывающие на преимущества данной методики перед классическим КШ. В силу этого в ближайшей перспективе MICS CABG можно рассматривать в качестве одного из основных методов миниинвазивной реваскуляризации миокарда.

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“…[13][14][15][16][17] As a result, the interest in minimally invasive CABG techniques is rapidly expanding. [18][19][20] Endoscopic or robotic harvesting of the internal thoracic artery (ITA) and the construction of ITA to left anterior descending artery (LAD) anastomosis under direct vision through a minithoracotomy (MIDCAB), 21 or in specialized centers by robot (TECAB), 22 with or without the use of cardiopulmonary bypass (CPB), are regarded as fundamental components to contemporary minimally invasive CABG strategies. The superiority of an ITA to LAD construction compared to other revascularization strategies is well reported.…”

Section: Introductionmentioning

confidence: 99%

Reasons for Conversion and Adverse Intraoperative Events in Robotically Enhanced Minimally Invasive Coronary Artery Revascularization

Merwe

Casselman

Vermeulen

et al. 2020

Innovations�(Phila)

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Objective The transition from sternotomy access to minimally invasive coronary artery bypass grafting is associated with steep learning curves. This study reports the reasons for sternotomy conversions from robotically enhanced minimally invasive direct coronary artery bypass grafting (RE-MIDCAB) and describes potential risk reduction strategies. Methods The perioperative data of 759 RE-MIDCAB patients (mean age 65.9 ± 10 years, 25.5% female, 30.2% multivessel disease) operated between July 1, 2002 and November 30, 2018 were reviewed for the reasons of conversion and adverse intraoperative events. Hybrid revascularization was planned in 204 (26.9%) patients. Results Sternotomy conversion occurred in 30 (4.0%) patients. Lung adhesions and unsuccessful single-lung ventilation prohibited safe RE-MIDCAB internal thoracic artery (ITA) harvesting in 11 (36.7%) and 1 (3.3%) patients, respectively. ITA dysfunction ( n = 11, 36.7%) and inadequate target vessel visualization ( n = 3, 10.0%) were among the anatomical reasons for conversions. Adverse intraoperative events included ventricle perforation ( n = 1, 3.3%) and sustained ventricular arrhythmia ( n = 1, 3.3%). The in-hospital mortality and mean length of hospitalization for sternotomy conversion were 3.3% ( n = 1 of 30) and 13.4 ± 14.5 days, respectively. Perioperative morbidities included pneumonia ( n = 4, 13.3%). Premorbid renal dysfunction predicted sternotomy conversion at the 5% level of significance. Conclusions RE-MIDCAB provides an attractive surgical platform for primary- or hybrid coronary artery procedures. The progressive increase in patient risk profiles, strict quality control, and focus on clinical governance require awareness of reasons that potentially contribute RE-MIDCAB to sternotomy conversion to ensure safe and sustainable programs.

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Robotic totally endoscopic coronary artery bypass grafting (TECAB)—placement of bilateral internal mammary arteries to the left ventricle

Cited by 6 publications

References 6 publications

Minimally invasive surgical coronary artery revascularization—current status and future perspectives in an era of interventional advances

Minimally invasive surgical coronary artery revascularization—current status and future perspectives in an era of interventional advances

Minimally invasive coronary artery bypass surgery

Reasons for Conversion and Adverse Intraoperative Events in Robotically Enhanced Minimally Invasive Coronary Artery Revascularization

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