Ming Yang1, Yang Wu1, Gang Wang1, Cangsong Xiao1, Huajun Zhang1, Changqing Gao2. 1. Department of Cardiovascular Surgery, Institute of Cardiac Surgery, PLA General Hospital, Beijing, China. 2. Department of Cardiovascular Surgery, Institute of Cardiac Surgery, PLA General Hospital, Beijing, China. Electronic address: gaochq301@yahoo.com.
Abstract
BACKGROUND: Coronary artery bypass grafting (CABG) is the gold-standard treatment for coronary artery disease, but the long-term benefits of robotic CABG remain unclear. METHODS: Between January 2007 and November 2014, 240 consecutive patients (187 male and 53 female, average age 59 years) underwent robotic off-pump CABG with the da Vinci Surgical System (Intuitive Surgical, Sunnyvale, CA) in our center. Totally endoscopic coronary artery bypass (TECAB) (n = 100) or mini-thoracotomy coronary artery bypass (MINICAB) (n = 140) grafting was performed with skeletonized internal mammary arteries (IMA). Patients were followed up and graft patency was assessed every 6 months by coronary angiography or 64-multi-slide computed tomographic angiography. RESULTS: All cases were completed without conversion to median sternotomy or cardiopulmonary bypass. A total of 237 single IMA grafts (98.3%) and 4 bilateral IMA grafts (1.7%) were used. No operative mortality was observed. Hybrid revascularization of non-left anterior descending vessels was performed in 24 patients (10%). No death, stroke, or myocardial infarction occurred in the follow-up of 41.1 ± 12.9 months. All grafts were patent before discharge. The IMA graft patency was 97.1% in TECAB and 96.4 % in MINICAB over 3 years (up to 91 months) postoperatively. CONCLUSIONS: Robotic off-pump CABG using IMA grafts is a safe and effective procedure in selected patients. The long-term outcome and patency of IMA grafts are excellent.
BACKGROUND: Coronary artery bypass grafting (CABG) is the gold-standard treatment for coronary artery disease, but the long-term benefits of robotic CABG remain unclear. METHODS: Between January 2007 and November 2014, 240 consecutive patients (187 male and 53 female, average age 59 years) underwent robotic off-pump CABG with the da Vinci Surgical System (Intuitive Surgical, Sunnyvale, CA) in our center. Totally endoscopic coronary artery bypass (TECAB) (n = 100) or mini-thoracotomy coronary artery bypass (MINICAB) (n = 140) grafting was performed with skeletonized internal mammary arteries (IMA). Patients were followed up and graft patency was assessed every 6 months by coronary angiography or 64-multi-slide computed tomographic angiography. RESULTS: All cases were completed without conversion to median sternotomy or cardiopulmonary bypass. A total of 237 single IMA grafts (98.3%) and 4 bilateral IMA grafts (1.7%) were used. No operative mortality was observed. Hybrid revascularization of non-left anterior descending vessels was performed in 24 patients (10%). No death, stroke, or myocardial infarction occurred in the follow-up of 41.1 ± 12.9 months. All grafts were patent before discharge. The IMA graft patency was 97.1% in TECAB and 96.4 % in MINICAB over 3 years (up to 91 months) postoperatively. CONCLUSIONS: Robotic off-pump CABG using IMA grafts is a safe and effective procedure in selected patients. The long-term outcome and patency of IMA grafts are excellent.
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