Robotically assisted coronary artery bypass graft surgery versus drug‐eluting stents for patients with stable isolated proximal left anterior descending disease

Abstract

Objective To compare the midterm outcomes of patients with isolated left anterior descending disease (iLAD) who underwent robotically assisted coronary artery bypass graft (R‐CABG) and percutaneous coronary intervention (PCI) with drug eluting stents (DES). Method Clinic data was collected in 223 patients who underwent R‐CABG in our hospital between July, 2007 to November, 2014. Cardiology Database System of our hospital was used to identify 4047 patients who underwent PCI with DES for LAD lesion between April, 2011 to November, 2014. Total 496 patients received DES and 108 patients underwent R‐CABG after screening. Patients were propensity matched into 108 R‐CABG and DES pairs according to vital statistic. Mortality, myocardial infarction (MI), stroke, repeat target lesion revascularization (r‐TLR), main adverse cardiac and cerebral events (MACCE), and angina relief were compared across pairs. Result Kaplan–Meier estimates for R‐CABG and DES had no significant difference in mortality (p = 1.00), MI (p = .32), Stroke (p = .80), and MACCE (p = .47), but the rate of r‐TLR (p = .03) were lower in R‐CABG group. Patients who underwent R‐CABG had better angina relief (p = .02), lower rate of arrhythmia (p < .001), and recurrent angina (p = .02) after operation compared patients received DES. Conclusion R‐CABG offers lower r‐TLR rate and better angina relief compared with DES for revascularization in patients with isolated proximal LAD stenosis and there was no difference in mortality, MI, stroke, and MACCE between them.

Minimally invasive surgical coronary artery bypass in women

“…Minimally invasive CABG is associated with a ten-year survival of 76-90% (40,41,43,44,47) and freedom from MACCE of 70-85% (40,43,44). The incidence of target vessel reintervention following minimally invasive CABG is ≤5% (37,(42)(43)(44)47,49,50), which is significantly lower than PCI for isolated LAD disease (37,42,45,49,50).…”

Alternative Approaches to Coronary Artery Bypass Grafting Versus Percutaneous Coronary Intervention, How Do They Compare?: A Systematic Review and Meta-Analysis

“…17,[42][43][44] While Lee, Moreyra, and Yin investigated outcomes following OPCAB and PCI. [45][46][47] A total of 251,740 patients were included in all studies, although the vast majority of patients (246,832) were enrolled in 1 study. 46 Data collection dates ranged from 2001 to 2017.…”

Minimally Invasive Direct Coronary Artery Bypass Versus Percutaneous Coronary Intervention for Isolated Left Anterior Descending Artery Stenosis: An Updated Meta-Analysis

“…However, the optimal revascularization strategy for isolated LAD lesions remains controversial. Several recent randomized controlled trials (RCTs), observational studies, and meta-analyses revealed no additional benefit in survival and MACEs from MIDCAB compared with PCI [Blazek 2013;Blazek 2015;Li 2021]. Nevertheless, other reports have demonstrated that MIDCAB offered superior freedom from MACEs in comparison with PCI [Etienne 2013;Iakovou 2002].…”