Technical challenges in totally endoscopic robotic coronary artery bypass grafting

Bonatti, Johannes; Schachner, Thomas; Bonaros, Nikolaos; Öhlinger, Armin; Danzmayr, M.; Jonetzko, Patrycja; Friedrich, Guy; Kolbitsch, Christian; Mair, Peter; Laufer, Günther

doi:10.1016/j.jtcvs.2005.07.064

Cited by 92 publications

(49 citation statements)

References 10 publications

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“…The sternotomy group consisted of patients in whom the anastomosis of the LIMA to the left anterior descending artery (LAD) was performed with the telemanipulator in conjunction with conventionally sutured grafts to targets other than the LAD [9, 11]. No patient with incomplete revascularization was included in the study.…”

Section: Methodsmentioning

confidence: 99%

Quality of Life Improvement after Robotically Assisted Coronary Artery Bypass Grafting

Bonaros¹,

Schachner²,

Wiedemann³

et al. 2009

Cardiology

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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.

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Section: Methodsmentioning

confidence: 99%

Quality of Life Improvement after Robotically Assisted Coronary Artery Bypass Grafting

Bonaros¹,

Schachner²,

Wiedemann³

et al. 2009

Cardiology

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“…Concurrent HCR could reduce the risk of bleeding with a “modified antiplatelet and anticoagulation protocol,” which includes continuous use of aspirin perioperatively and a loading dose thienopyridines immediately before PCI [30]. The risk of stent thrombosis may also be greater due to the proinflammatory milieu during surgery [25, 31]. …”

Section: Concurrent Versus Staged Hcrmentioning

confidence: 99%

Hybrid Revascularization: A Review

Saha

Naqvi

Goldberg³

2018

Cardiology

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Hybrid coronary revascularization (HCR) combines surgical bypass with percutaneous coronary intervention (PCI) performed either during the same procedure or in a staged approach within 60 days. Coronary artery bypass grafting using the left internal mammary artery (LIMA) has shown excellent long-term patency with improved patient survival. It remains the gold standard treatment for the majority of patients with multivessel coronary artery disease. However, saphenous vein grafts have poor long-term patency. Advances in stent technology have resulted in reduced rates of thrombosis and restenosis, making PCI a viable alternative to coronary surgery in selected patients. HCR is attractive as a less invasive method of coronary revascularization which preserves the benefits of the LIMA performed with less invasive surgical techniques with the efficacy of newer generation stents.

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“…Subsequently, there has been interest both in traditional arrested-heart TECAB with cardiopulmonary bypass and in beating-heart, off-pump TECAB with the use of endoscopic stabilizers. Although issues have been raised regarding technical challenges and conversion rates [60][61][62] , there are also data that suggest that with appropriate techniques and experience, excellent graft patency rates can be achieved [63] .…”

Section: Other Potential Surgical Interventionsmentioning

confidence: 99%

Surgical revascularization for acute coronary syndromes: a narrative review

Joo¹,

Liao²,

Bakaeen³

et al. 2018

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Acute coronary syndrome (ACS) comprises a spectrum of disease that includes unstable angina, non-ST-elevation myocardial infarction, and ST-elevation myocardial infarction. Clinical management of patients with ACS has greatly evolved over the last two decades, but ACS remains an important cause of morbidity and mortality in patients with coronary artery disease. This narrative review describes the indication, timing, and approaches to surgical revascularization in the context of ACS. In particular, the review discusses and compares the utilization of off-pump coronary artery bypass grafting (CABG) vs . conventional on-pump CABG. Other surgical interventions, such as totally endoscopic coronary artery bypass and hybrid coronary revascularization, are also reviewed.

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Technical challenges in totally endoscopic robotic coronary artery bypass grafting

Cited by 92 publications

References 10 publications

Quality of Life Improvement after Robotically Assisted Coronary Artery Bypass Grafting

Quality of Life Improvement after Robotically Assisted Coronary Artery Bypass Grafting

Hybrid Revascularization: A Review

Surgical revascularization for acute coronary syndromes: a narrative review

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