Quality of Life Improvement after Robotically Assisted Coronary Artery Bypass Grafting

Bonaros, Nikolaos; Schachner, Thomas; Wiedemann, Dominik; Oehlinger, Armin; Ruetzler, Elisabeth; Feuchtner, Gudrun; Kolbitsch, Christian; Velik‐Salchner, Corinna; Friedrich, Guy; Pachinger, Othmar; Laufer, Guenther; Bonatti, Johannes

doi:10.1159/000212115

Cited by 98 publications

(66 citation statements)

References 69 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The practice of robot-assisted mitral valve repair (MVR) offers numerous potential benefits to patients including shorter hospital length of stay (1)(2)(3), reduced postoperative pain (4), a lower rate of surgical site infection (4), diminished incidence of blood product transfusion (5,6), a faster return to normal daily activities (5,7), and greater overall patient satisfaction (4). Anesthesiologists play in a key role in facilitating optimal outcomes after robotic MVR.…”

Section: Perspectivementioning

confidence: 99%

Anesthetic considerations in robotic mitral valve surgery

Rehfeldt

Andre

Ritter

2017

Ann. Cardiothorac. Surg.

View full text Add to dashboard Cite

The robotic approach to cardiac surgery offers patients numerous potential advantages compared with a traditional sternotomy approach including shorter hospital length of stay, reduced pain, fewer blood transfusions, and a quicker return to normal daily activities. At the same time, robotic cardiac surgery requires that the anesthesiologist employs several subspecialty skillsets in order to provide optimal care for these patients. Multiple different regional anesthesia techniques may be used to improve analgesia, reduce opioid dosages, and facilitate rapid extubation at the conclusion of the case. Several peripheral cannulation strategies for cardiopulmonary bypass (CPB) exist and the anesthesia team may assist with percutaneous cannulation of the superior vena cava (SVC) or positioning of an endo-pulmonary vent. Similarly the anesthesiologist may be asked to percutaneously cannulate the coronary sinus for retrograde cardioplegia delivery. The need for one-lung ventilation (OLV) and heavy reliance on transesophageal echocardiography (TEE) occupy much of the anesthesiologist's attention during these cases. Variations in institutional practice exist. Reviews of current practice and future studies may help refine the anesthetic approach to robot-assisted cardiac surgery.

show abstract

Section: Perspectivementioning

confidence: 99%

Anesthetic considerations in robotic mitral valve surgery

Rehfeldt

Andre

Ritter

2017

Ann. Cardiothorac. Surg.

View full text Add to dashboard Cite

show abstract

“…Patients converted to sternotomy experienced similar courses to standard sternotomy patients in terms of QOL. 21 Srivastava et al reported in 2009 on 214 patients in Odessa, Texas, who underwent successful beating-heart TECAB from July 2004 to June 2007. Single-, double-, and triple-vessel beating-heart TECAB was performed in 139, 68, and 7 patients, respectively; 50 patients underwent a planned hybrid revascularization and 80% of patients (172 of 214) underwent computed tomography angiography (CTA) or conventional angiography within 3 months of surgery.…”

Section: Developments In 2006-2010mentioning

confidence: 99%

History and Current Status of Robotic Totally Endoscopic Coronary Artery Bypass

Lee

Srivastava

Bonatti³

2012

Circ J

Self Cite

View full text Add to dashboard Cite

Robotic totally endoscopic coronary artery bypass (TECAB) is a minimally invasive endoscopic surgical approach using the daVinci robotic telemanipulation system to perform coronary artery bypass grafting on the arrested or beating heart. It is a procedure that can be a useful alternative to the classic open procedure performed through sternotomy. After extensive modeling in cadavers, the first clinical case was performed in June 1998 placing a left internal thoracic artery graft (LITA) to the left anterior descending artery completely robotically on the arrested heart. During the early and late 2000 s, international groups have adopted this evolving technology, which has included iterations such as beating-heart TECAB, use of bilateral ITA grafting and radial artery grafting, as well as 3- and 4-vessel TECAB. TECAB is combined with percutaneous coronary intervention in hybrid procedures. Despite increasing complexity of endoscopic coronary bypass surgery, conversion rates to open bypass surgery have dropped significantly and operative times have decreased. Published major morbidities and mortality rates in arrested- and beating-heart TECAB have been cumulatively in the 0-2% range and are considered well within the expected range for these highly complex surgical procedures. Long-term survival and freedom from major adverse events also meet the standards of open bypass surgery. (Circ J 2012; 76: 2058 - 2065

show abstract

“…For patients after sternotomy off-pump CABG, this time was 4.4 months. Bonaros et al 42 compared Short Form-36 scores for patients after AHTECAB versus patients after conversion to sternotomy and primary sternotomy. At 1 month postoperatively, scores for general health were higher after TECAB.…”

Section: Effects Of Reduced Surgical Traumamentioning

confidence: 99%