Robot-assisted minimally invasive coronary artery bypass in treating multi-vessel coronary artery disease: A retrospective study in a single center
- VernacularTitle:机器人辅助微创冠状动脉血运重建治疗冠心病多支血管病变的单中心回顾性研究
- Author:
Yuqian XIE
1
;
Liyue ZHANG
1
;
Nan CHENG
2
;
Shiyong DONG
2
;
Hua SHEN
2
;
Rong WANG
2
Author Information
1. Medical School of Chinese PLA, 100853, Beijing, P. R. China
2. Department of Adult Cardiovascular Surgery, Senior Department of Cardiology, The Sixth Medical Center of PLA General Hospital, 100048, Beijing, P. R. China
- Publication Type:Journal Article
- Keywords:
Coronary artery disease;
multi-vessel disease;
robot-assisted surgery;
coronary artery bypass grafting;
hybrid coronary revascularization
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2023;30(05):724-730
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the early and mid-term results of robot-assisted coronary artery bypass grafting (RACAB) in the treatment of multi-vessel coronary artery disease (MV-CAD). Methods Patients with MV-CAD who underwent RACAB from April 2018 to December 2021 in our hospital were included. Patients who underwent hybrid coronary revascularization (HCR) which combined RACAB with percutaneous coronary intervention were allocated to a HCR-RACAB group, and patients who underwent multi-vessel RACAB were allocated to a MV-RACAB group. Perioperative and follow-up data were collected and compared between the two groups. Results A total of 102 patients were included, including 81 males and 21 females with a mean age of 61.7±10.8 years. Two (2.0%) patients were transferred to conventional CABG due to sudden ventricular fibrillation and pleura adhesion. In the remaining 100 patients who underwent RACAB, 100 left internal mammary arteries (LIMA) and 46 right internal mammary arteries (RIMA) were harvested with a 100.0% success rate. Besides, all patients undergoing RACAB achieved LIMA/RIMA-left anterior descending branch reconstruction, with an average number of 2.5±0.6 target vessels revascularized by stent or graft. One patient had perioperative myocardial infarction with an outcome of death. The incidence of major perioperative adverse events was 1.0%. There was no perioperative stroke or re-sternotomy for hemostasis. The mean follow-up time was 28.2 months, with a follow-up rate of 99.0% and an overall major adverse cardiac and cerebrovascular event (MACCE) rate of 7.0%, including 3 all-cause deaths (3.0%), 2 strokes (2.0%) and 3 re-revascularizations (3.0%). The HCR-RACAB group had fewer red blood cell transfusion (P=0.030) and intraoperative blood loss (P=0.037) compared with the MV-RACAB group, and there was no statistical difference in the incidence of major perioperative adverse events or MACCE between the two groups during the follow-up period (P>0.05). Conclusion RACAB can be safely applied in the treatment of MV-CAD with good early and mid-term outcomes. High-quality harvesting of LIMA/RIMA and aortic no-touch technique are crucial to achieve these results.
