Long-Term Clinical and Computed Tomography Angiographic Follow-Up after Totally Endoscopic Coronary Artery Bypass Grafting

Stastny, Lukas; Kofler, Markus; Dumfarth, Julia; Basaran, Alim; Wiedemann, Dominik; Schachner, Thomas; Feuchtner, Gudrun; Bonatti, Johannes; Bonaros, Nikolaos

doi:10.1097/imi.0000000000000461

Cited by 8 publications

(5 citation statements)

References 27 publications

(26 reference statements)

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“…Some factors influenced the quick recovery, including the surgeon's experience, learning-curve effect, cooperation of physician and surgeon, and postoperative management [Hart 1999]. The RCABG was blunted compared with the conventional CABG due to the inflammatory response, for example, the cytokine and C-reactive protein release [Stastny 2018]. A similar clinical outcome showed no significant difference between conventional CABG and RCABG and fewer blood products, shorter ICU stay, hospital stay, and less pain compared with conventional CABG [Messerli 2018].…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive CABG or Hybrid Coronary Revascularization for Multivessel Coronary Diseases: Which Is Best? A Systematic Review and Metaanalysis

Guan

Zhang

et al. 2019

HSF

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Objectives: Minimally invasive coronary revascularization (MICR) involves minimally invasive direct coronary artery bypass grafting (MIDCAB) and robotic-assisted coronary artery bypass grafting (RCABG), and hybrid coronary revascularization (HCR) aims to combine MICR/RCABG on left anterior descending (LAD) and percutaneous coronary interventions (PCI) on non-LAD lesions. We performed a systematic review and metaanalysis to compare clinical outcome after MICR and HCR. Methods: A metaanalysis was carried out through searching PubMed, EMBASE, Web of Science, and Medline for comparative studies evaluating the primary and secondary clinical end points. Results: A systematic literature search identified 8 observational studies that satisfied our inclusion criteria, including being suitable for metaanalysis; the studies were between 1990 and 2018 and included 1084 cases of HCR and 2349 cases of MICR. Metaanalysis of these studies showed that HCR was associated with a reduced need for ICU LOS (WMD –11.46 hours, 95% CI, –18.76 ~ –4.25, P = .02), to hospital time (WMD –1.34 hours, 95% CI, –2.42 to 0.26, P < .01), and blood transfusion (OR 0.43, 95% CI, 0.31-0.59, P < .00001) than MICR. Comparisons of individual components showed no significant difference in terms of in-hospital mortality, MACCE, shock, myocardial infarction (MI), long-term survival, total variable cost, and surgical complications (including renal failure, chest drainage, bleeding). Conclusions: HCR was noninferior to MICR in terms of in-hospital mortality, MACCE, shock, MI, long-term survival, total variable cost, and surgical complications (including renal failure, chest drainage, bleeding), whereas HCR was associated with a reduced need for ICU LOS, hospital time, and blood transfusion than MICR and less infection than MICR. Further randomized studies are warranted to corroborate these observational data.

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Section: Discussionmentioning

confidence: 99%

Minimally Invasive CABG or Hybrid Coronary Revascularization for Multivessel Coronary Diseases: Which Is Best? A Systematic Review and Metaanalysis

Guan

Zhang

et al. 2019

HSF

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“…Stastny et al proved that arrested heart TECAB resulted in excellent clinical long-term outcomes with a LIMA artery patency rate comparable with conventional CABG at 10 years after surgery. [ 64 ]…”

Section: Techniques Of Minimally Invasive Coronary Artery Bypass Graftingmentioning

confidence: 99%

Minimally Invasive Coronary Revascularisation Surgery: A Focused Review of the Available Literature

et al. 2021

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Minimally invasive coronary revascularisation was originally developed in the mid 1990s as minimally invasive direct coronary artery bypass (MIDCAB) grafting is a less invasive approach compared to conventional coronary artery bypass grafting (CABG) to address targets in the left anterior descending coronary artery (LAD). Since then, MIDCAB has evolved with the adoption of a robotic platform and the possibility to perform multivessel bypass procedures. Minimally invasive coronary revascularisation surgery also allows for a combination between the benefits of CABG and percutaneous coronary interventions for non-LAD lesions – a hybrid approach. Hybrid coronary revascularisation results in fewer blood transfusions, shorter hospital stay, decreased ventilation times and patients return to work sooner when compared to conventional CABG. This article reviews the available literature, describes standard approaches and considers topics, such as limited access procedures, indications and patient selection, diagnostics and imaging, techniques, anastomotic devices, hybrid coronary revascularisation and outcome analysis.

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“…15 Recently, Stastny and colleagues summarized 208 AH-TECAB cases over 11 years, and the graft patency by CTA assessment was 100%, 94.9%, and 88.1% at 1, 5, and 10 years in 67 patients who had isolated LIMA-LAD bypass. 24 Early Graft Patency after BH-TECAB…”

Section: Long-term Graft Patency After Ah-tecabmentioning

confidence: 99%

Graft Patency after Robotically Assisted Coronary Artery Bypass Surgery

Kuwabara

Nisivaco

Balkhy

2019

Innovations�(Phila)

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Objective With advances in robotic instrumentation and technology, both robotically assisted minimally invasive direct coronary artery bypass (RMIDCAB) and totally endoscopic coronary artery bypass (TECAB) have been widely used over the past 20 years. Graft patency is the most important outcome in coronary bypass surgery and is associated with long-term prognosis. In this article we reviewed all experts’ studies in the field of robotic assisted coronary artery bypass and investigated graft patency in patients who underwent RMIDCAB or TECAB. Methods We performed a literature search in PubMed from 1999 to 2018 using the terms “Robotic” and “Coronary bypass” and/or “Minimally invasive” and/or “Totally endoscopic.” Of the articles found, studies investigating graft patency were specifically selected. Results In 33 articles, a total of 4,000 patients underwent robotic assisted coronary artery bypass surgery either by a RMIDCAB (2,396) or by a TECAB (1,604) approach. The graft patency was assessed by invasive angiography or computed tomographic angiography in all studies. The mean graft patency at early (<1 month), midterm (<5 years), and long-term (>5 years) follow-up was 97.7%, 96.1%, and 93.2% in RMIDCAB and 98.8%, 95.8%, and 93.6% in TECAB, respectively. Conclusions The graft patency of robotic assisted coronary artery bypass was equivalent to reported outcomes of the conventional approach. These results should encourage the adoption of robotic approaches in coronary bypass surgery.

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Long-Term Clinical and Computed Tomography Angiographic Follow-Up after Totally Endoscopic Coronary Artery Bypass Grafting

Cited by 8 publications

References 27 publications

Minimally Invasive CABG or Hybrid Coronary Revascularization for Multivessel Coronary Diseases: Which Is Best? A Systematic Review and Metaanalysis

Minimally Invasive CABG or Hybrid Coronary Revascularization for Multivessel Coronary Diseases: Which Is Best? A Systematic Review and Metaanalysis

Minimally Invasive Coronary Revascularisation Surgery: A Focused Review of the Available Literature

Graft Patency after Robotically Assisted Coronary Artery Bypass Surgery

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