Literature DB >> 28542076

Comparative Analysis of Perioperative and Mid-Term Results of TECAB and MIDCAB for Revascularization of Anterior Wall.

Markus Kofler1, Thomas Schachner, Sebastian J Reinstadler, Lukas Stastny, Julia Dumfarth, Dominik Wiedemann, Gudrun Feuchtner, Guy Friedrich, Johannes Bonatti, Nikolaos Bonaros.   

Abstract

OBJECTIVE: Totally endoscopic coronary artery bypass (TECAB) and minimally invasive direct coronary artery bypass (MIDCAB) grafting through minithoracotomy are currently the two minimally invasive surgical techniques of left ventricular anterior wall revascularization. We aimed to compare both techniques in terms of perioperative and mid-term results.
METHODS: Arrested heart TECAB was carried out in 204 patients with a median (range) age of 60 (53-76) years and a median (range) EuroSCORE I of 2 (0-3). Minimally invasive direct coronary artery bypass was performed in 60 patients with a median (range) age of 66 (54-75) years and a median (range) EuroSCORE I of 2 (1-5). Both techniques were used for single or sequential internal mammary artery grafts to the anterior wall. Operative times, conversion rates, and surgical complications as well as mid-term results were compared between the groups after a median follow-up of 36 months.
RESULTS: No perioperative deaths were noted. Rates of myocardial infarction (TECAB: 1.5% vs MIDCAB: 0%, P = 0.463) and stroke (TECAB: 1.5% vs MIDCAB: 0%, P = 0.454) were not significantly different between the groups. Total operative times were longer in the TECAB compared with the MIDCAB group [292 (250-345) minutes in TECAB versus 201 (173-289) minutes in MIDCAB (P < 0.001)]. Intensive care unit stay and total length of stay were similar between the groups. There was no difference in mid-term survival (TECAB: 1.5% vs MIDCAB: 1.7%, P = 0.298) and freedom from major adverse cardiac and cerebrovascular events (TECAB: 12.4% vs MIDCAB: 5.1%, P = 0.358).
CONCLUSIONS: Robotically assisted arrested heart TECAB and robotic MIDCAB perform equally in terms of perioperative results and mid-term follow-up in this single-center patient cohort.

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Year:  2017        PMID: 28542076     DOI: 10.1097/IMI.0000000000000378

Source DB:  PubMed          Journal:  Innovations (Phila)        ISSN: 1556-9845


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