Robotically Assisted Totally Endoscopic Coronary Bypass Surgery

Bonatti, Johannes; Schachner, Thomas; Bonaros, Nikolaos; Lehr, Eric J.; Zimrin, David; Griffith, Bartley P.

doi:10.1161/circulationaha.110.985267

Cited by 77 publications

(42 citation statements)

References 44 publications

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“…We have published our TECAB results alone and as combinations of TECAB with PCI in hybrid coronary revascularization (1,2,5). Results appear to meet the standards of standard CABG through sternotomy.…”

Section: Clinical Resultsmentioning

confidence: 82%

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

Bonatti

Vento²,

Bonaros

et al. 2016

Ann. Cardiothorac. Surg.

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Section: Clinical Resultsmentioning

confidence: 82%

“…The procedure has evolved from single left internal mammary artery (LIMA) bypass grafting of the left anterior descending (LAD) artery to complex multivessel surgical revascularization (1,2). The main advantage of an endoscopic approach is reduced surgical trauma and earlier recovery.…”

mentioning

confidence: 99%

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

Bonatti

Vento²,

Bonaros

et al. 2016

Ann. Cardiothorac. Surg.

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“…The robotic technique for coronary artery bypass surgery demonstrated reduction in surgical trauma whilst maintaining thoracic integrity. Many studies show reduction of the early postoperative time period with a faster return to full activity (14). Robotic technique for intracardiac tumors allowed for complete resection of the mass without sternotomy.…”

Section: Discussionmentioning

confidence: 99%

Robotic cardiac surgery in Brazil

Poffo

Toschi

Pope

et al. 2017

Ann. Cardiothorac. Surg.

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Background: Brazil, the largest country and economy in South America, is a major driving force behind the development of new medical technologies in the region. Robotic cardiac surgery (RCS) has been evolving rapidly since 2010, when the first surgery using the DaVinci ® robotic system was performed in LatinAmerica. The aim of this article is to evaluate short and mid-term results in patients undergoing robotic cardiac surgery in Brazil.Methods: From March 2010 to December 2015, 39 consecutive patients underwent robotic cardiac surgery. Twenty-seven patients were male (69.2%), with the mean age of 51.3±17.9 years. Participants had a mean ejection fraction of 62±5%. The procedures included in this study were mitral valve surgery, surgical treatment of atrial fibrillation, atrial septal defect closure, resection of intra-cardiac tumors, totally endoscopic coronary artery bypass and pericardiectomy.Results: The mean time spent on cardiopulmonary bypass (CPB) during RCS was 154.9±94.2 minutes and the mean aortic cross-clamp time was 114.48±75.66 minutes. Thirty-two patients (82%) were extubated in the operating room immediately after surgery. The median intensive care unit (ICU) length of stay was 1 day (ranging from 0 to 25) and the median hospital length of stay was 5 days (ranging from 3 to 25). For each type of procedure, endpoints were individually reported. There were no conversions to sternotomy and no intra-operative complications. Patient follow-up was complete in 100% of the participants, with two early deaths unrelated to the procedures and no re-operations at mid-term.Conclusions: Despite the heterogeneity of this series, RCS appears to be feasible, safe and effective when used for the correction of various intra-and extra-cardiac pathologies. Adopting the robotic system has been a challenge in Brazil, where its limited clinical application may be related to the lack of specific training and the high cost of technology.

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“…Three main options for the performance of CABG without sternotomy are now available (Table 3): (1) minimally invasive CABG, in which all areas of the heart are bypassed via a small left anterolateral thoracotomy, usually without the use of the heart–lung machine123; (2) robotic total endoscopic coronary bypass grafting, in which robotic techniques are used not only for internal mammary artery harvest but also for the performance of all graft anastomoses124; and (3) HCR, which combines the performance of a single LIMA‐LAD graft via a small anterolateral thoracotomy, with PCI to the other myocardial territories of the heart that require revascularization 125…”

Section: Minimally Invasive Cabg Total Endoscopic Coronary Artery Bymentioning

confidence: 99%