Correção cirúrgica da comunicação interatrial e revascularização do miocárdio minimamente invasiva videoassistida

Poffo, Robinson; Pope, Renato Bastos; Toschi, Alisson Parrilha

doi:10.1590/s0102-76382009000500025

Cited by 5 publications

(5 citation statements)

References 3 publications

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“…[13–16] In the field of coronary revascularization, the goal for minimally invasive approaches has led to a wider application of PCI, despite its association with more reinterventions. Over the past 2 decades, robot-assisted cardiovascular surgery using the Da Vinci system, which combines the advantages of 2 revascularization methods (like the smaller wounds, less rib retraction, less pain, prompt return to normal activities and a positive impact on the quality of life), [5,17] has been increasingly used worldwide to treat congenital heart disease, [11,12] VHD, [9,10] and CAD. [5–8] Despite the fact that contemporary standard CABG being the major approach in most hospitals across the world and its outstanding results with acceptable hospital stays and peri-operative complications, [8] CABG still might not be adopted due to concerns of religions, multiple comorbidities, advanced ages and frailty and the demand of less traumatic alternatives.…”

Section: Discussionmentioning

confidence: 99%

“…It remains debatable as to whether other modality may be an even more effective treatment. [1–4] Recently, the robot-assisted CABG (R-CABG) has been applied more widely to treat complex CAD, [5–8] valvular heart disease (VHD), [9,10] and congenital heart disease [11,12] mainly because its advantages over the conventional open heart surgery, namely: shorter ICU and hospital stays, lower blood transfusion requirement, fewer post-operative complications, and better post-operative quality of life. R-CABG combines the dual benefits of PCI and the conventional CABG (C-CABG).…”

Section: Introductionmentioning

confidence: 99%

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Clinical outcomes of patients with multivessel coronary artery disease treated with robot-assisted coronary artery bypass graft surgery versus one-stage percutaneous coronary intervention using drug-eluting stents

Shen

Chang

et al. 2019

Medicine

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A number of studies have reported on treatment outcomes of coronary stenting (PCI) for multivessel coronary artery diseases (MVD), and compared them with the conventional coronary artery bypass grafting (CABG). However, the clinical outcomes of robot-assisted CABG (R-CABG) in comparison with PCI in MVD patients have not been investigated.We recruited retrospectively MVD patients receiving R-CABG and PCI with drug-eluting stents for all vessels in one stage between January 2005 and December 2013 at our institution with at least 3 years of outcomes were retrospectively recruited and analyzed.A total of 638 MVD patients were studied. Among them, 281 received R-CABG, and 357 received PCI. Similar complete revascularizations were achieved in both groups (R-CABG: 40.2%, PCI: 41.5%, P = .751). The residual stenosis was 4.1 ± 4.4 in the R-CABG group, and comparably 3.5 ± 3.7 in the PCI group (P = .077). Patients in the R-CABG group were younger, with more severe coronary artery disease (CAD) and had more background risk factors. The in-hospital and long-term mortalities as well as the incidence of TLR, myocardial infarction (MI), stroke were all similar between groups. But the incidence of TVR and any revascularization were lower in the R-CABG group. The long-term mortality was predicted by age, left ventricular ejection fraction, and chronic kidney disease, but not by the revascularization modality, completeness of revascularization, nor residual SYNTAX scores. The last 3 factors were not predictors of long-term TLR, TVR, MI, and stroke.The in-hospital and long-term survival rates of MVD were similar for both the R-CABG and PCI groups. But the R-CABG group had rates of TVR and any revascularization lower than PCI. Revascularization modality, completeness of revascularization, and residual SYNTAX scores were not predictors of in-hospital and long-term mortalities, MI, and stroke in real-world practice. R-CABG was associated with lower rates of TLR and TVR, and is likely a safe and effective treatment and an alternative choice of PCI for MVD patients who have low surgical risks.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical outcomes of patients with multivessel coronary artery disease treated with robot-assisted coronary artery bypass graft surgery versus one-stage percutaneous coronary intervention using drug-eluting stents

Shen

Chang

et al. 2019

Medicine

View full text Add to dashboard Cite

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“…[ 10 – 14 ] In the field of cardiovascular treatment, the desire for a minimally invasive method of revascularizing the heart has also led to the widespread use of PCI even though in complex cases of CAD, CABG has been shown to be more efficacious, with lower rates of mortality, MI, and reintervention in mid- and long-term follow-up. During the past 2 decades, there has been a significant increase worldwide in the use of robot-assisted cardiovascular surgery using the Da Vinci system, which combines the advantages of 2 revascularization methods to provide smaller wounds, less rib retraction, reduction in pain, and faster return to normal activities with a positive impact on the quality of life, [ 20 , 31 ] in patients with congenital [ 17 , 18 ] and valvular heart diseases, [ 15 , 16 ] and CAD. [ 19 – 22 ] However, R-CABG was mostly used for treating simple but not complex CAD because it is more time-consuming and technically demanding than C-CABG.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of left main coronary artery disease patients undergoing three different revascularization approaches

Chen

Shen

et al. 2018

Medicine

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Significant unprotected left main (LM) coronary artery disease is frequently associated with severe multivessel disease and increased mortality and morbidity compared with non-LM coronary artery disease. This study compared the clinical outcomes of patients with LM disease who received percutaneous coronary intervention (PCI) with stenting, conventional coronary-artery bypass grafting (C-CABG), and robot-assisted CABG (R-CABG).This retrospective study analyzed 472 consecutive LM disease patients who underwent three different revascularization approaches at a tertiary medical center between January 2005 and November 2013.Of the 472 LM disease patients, 139 received R-CABG, 147 received C-CABG, and 186 received PCI. The need for target vessel revascularization (TVR) was highest in the PCI group. The R-CABG group had significantly lower rates of in-hospital and follow-up all-cause deaths compared with the other 2 groups (1.4% vs. 3.4% and 9.7%, P = .0058; 13.7% vs. 29.3% and 29.6%, P = .0023, respectively). Patients in the R-CABG group had significantly lower rates of intra-aortic balloon pump assistance, and shorter duration of ICU and total hospital stay compared to patients in the C-CABG group. However, revascularization modality, SYNTAX scores, and residual SYNTAX scores were not independent predictors of in-hospital or long-term mortality.In this cohort of LM disease patients treated at a tertiary medical center, PCI is a reasonable choice in patients with less lesion complexity but who are older and have comorbidities. R-CABG is feasible in stable LM disease patients with high SYNTAX scores, and is an effective alternative to C-CABG in LM disease patients with few risk factors. However, revascularization modality per se was not a determinant for long-term mortality in our real-world practice.

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“…Within this concept, we have some articles in the national literature demonstrating this technique performed through small incisions, since the articles published by Jatene et al [6][7][8] . Later, Poffo et al 9 demonstrated the possibility of performing this surgery associated with other intracardiac diseases with minimum access and videosurgery equipment support.…”

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confidence: 99%

Cirurgia de revascularização do miocárdio minimamente invasiva

Poffo¹,

Celullare²

2012

Arq. Bras. Cardiol.

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Correção cirúrgica da comunicação interatrial e revascularização do miocárdio minimamente invasiva videoassistida

Abstract: POFFO, R ET AL -Minimally invasive video-assisted atrial septal defect correction and myocardial revascularization Rev Bras Cir Cardiovasc 2009; 24(4): 586-589 thread (Monocryl®). The other openings were closed using simple 5-0 nylon sutures. The dressings were prepared using micropore®.

Cited by 5 publications

References 3 publications

Clinical outcomes of patients with multivessel coronary artery disease treated with robot-assisted coronary artery bypass graft surgery versus one-stage percutaneous coronary intervention using drug-eluting stents

Clinical outcomes of patients with multivessel coronary artery disease treated with robot-assisted coronary artery bypass graft surgery versus one-stage percutaneous coronary intervention using drug-eluting stents

Clinical outcomes of left main coronary artery disease patients undergoing three different revascularization approaches

Cirurgia de revascularização do miocárdio minimamente invasiva

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