Robotic Total Arterial Off-Pump Coronary Artery Bypass Grafting: Seven-Year Single-Center Experience and Long-Term Follow-Up of Graft Patency

Yang, Ming; Wu, Yaling; Wang, Gang; Xiao, Chen; Zhang, Huajun; Gao, Changqing

doi:10.1016/j.athoracsur.2015.04.054

Cited by 43 publications

(27 citation statements)

References 33 publications

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“…In addition, studies of on-pump TECAB, such as the multiinstitutional study by Argenziano and colleagues, reported longer operative times due to the need for peripheral cannulation and use of a cardiopulmonary circuit (20). Finally, perioperative outcomes such as ventilation time, ICU stay, and total hospitalization time were dependent on clinical pathways specific to each institution, and prolonged times may have been multi-factorial (10).…”

Section: Discussionmentioning

confidence: 99%

“…After exclusion of duplicated studies and 546 irrelevant articles based on abstracts and titles, 126 studies remained for full-text evaluation. Of these, 44 studies met the inclusion criteria, including nine studies in the TECAB off-pump group (10)(11)(12)(13)(14)(15)(16)(17)(18); two studies in the TECAB on-pump group (19,20); and 16 studies in the robotic MIDCAB group (10,(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33). One study provided separate data for both the TECAB offpump and robotic MIDCAB groups, and was included for analysis in both groups (10).…”

Section: Resultsmentioning

confidence: 99%

“…Of these, 44 studies met the inclusion criteria, including nine studies in the TECAB off-pump group (10)(11)(12)(13)(14)(15)(16)(17)(18); two studies in the TECAB on-pump group (19,20); and 16 studies in the robotic MIDCAB group (10,(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33). One study provided separate data for both the TECAB offpump and robotic MIDCAB groups, and was included for analysis in both groups (10). Eighteen additional studies reported on a mixture of different surgical techniques (18,(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53).…”

Section: Resultsmentioning

confidence: 99%

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A systematic review on robotic coronary artery bypass graft surgery

Cao

Indraratna

Doyle

et al. 2016

Ann. Cardiothorac. Surg.

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Background: Robotic-assisted coronary artery bypass graft surgery (CABG) has been performed over the past decade. Despite encouraging results from selected centres, there is a paucity of robust clinical data to establish its clinical safety and efficacy. The present systematic review aimed to identify all relevant clinical data on robotic CABG. The primary endpoint was perioperative mortality, and secondary endpoints included perioperative morbidities, anastomotic complications, and long-term survival.Methods: Electronic searches were performed using three online databases from their dates of inception to 2016. Relevant studies fulfilling the predefined search criteria were categorized according to surgical techniques as (I) totally endoscopic coronary artery bypass without cardiopulmonary bypass (TECAB offpump); (II) TECAB on-pump; and robotic-assisted mammary artery harvesting followed by minimally invasive direct coronary artery bypass (robotic MIDCAB).Results: The present systematic review identified 44 studies that fulfilled the study selection criteria, including nine studies in the TECAB off-pump group and 16 studies in the robotic MIDCAB group.Statistical analysis reported a pooled mortality of 1.7% for the TECAB off-pump group and 1.0% for the robotic MIDCAB group. Intraoperative details such as the number and location of grafts performed, operative times and conversion rates, as well as postoperative secondary endpoints such as morbidities, anastomotic complications and long-term outcomes were also summarized for both techniques.Conclusions: A number of technical, logistic and cost-related issues continue to hinder the popularization of the robotic CABG procedure. Current clinical evidence is limited by a lack of randomized controlled trials, heterogeneous definition of techniques and complications, as well as a lack of robust clinical followup with routine angiography. Nonetheless, the present systematic review reported acceptable perioperative mortality rates for selected patients at specialized centres. These results should be considered as a useful benchmark for future studies, until further data is reported in the form of randomized trials.

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Section: Discussionmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

A systematic review on robotic coronary artery bypass graft surgery

Cao

Indraratna

Doyle

et al. 2016

Ann. Cardiothorac. Surg.

View full text Add to dashboard Cite

show abstract

“…Therefore, data are of limited usefulness in daily clinical practice. 20 In a recent study of Yang et al, 7 long-term graft patency rate was investigated in 140 MIDCAB and 100 TECAB procedures. They were able to show excellent graft patency rates for each procedure.…”

Section: Discussionmentioning

confidence: 99%

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

Stastny

Kofler

Dumfarth

et al. 2018

Innovations�(Phila)

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Objective Totally endoscopic coronary artery bypass grafting was shown to be feasible and safe, with excellent clinical and angiographic mid-term results. Data on long-term outcome are lacking. Therefore, we aimed to investigate the long-term rate of major adverse cardiac and cerebrovascular events and left internal mammary artery patency rate in patients undergoing arrested heart totally endoscopic coronary artery bypass grafting. Methods From 2001 to 2012, a total of 208 arrested heart-totally endoscopic coronary artery bypass grafting patients were prospectively included. Mean ± SD age was 58.8 ± 9.4 years, and mean ± SD Society of Thoracic Surgeons score was 0.5 ± 0.5%. Major adverse cardiac and cerebrovascular events were defined as a composite of death, myocardial infarction, stroke, re-percutaneous coronary intervention, re-coronary artery bypass graft, and target vessel revascularization. Left internal mammary artery patency was assessed using cardiac computed tomography and depicted according to the established Fitzgibbon classification. Mean ± SD follow-up was 6.9 ± 2.3 years. Results At 1, 5, and 10 years, survival rate was 100%, 98.3%, and 95.8%, respectively. The freedom from clinical events at 1, 5, and 10 years were major adverse cardiac and cerebrovascular events (93.5%, 85.9%, and 83.0%), myocardial infarction (99.0%, 97.4%, and 95.9%), target vessel revascularization (96.0%, 94.3%, and 91.7%), re-percutaneous coronary intervention (94.5%, 91.6%, and 84.2%), and re-coronary artery bypass graft (100%, 99.5%, and 99.5%), respectively. Left internal mammary artery patency rate at 1, 5, and 10 years was 100%, 94.9%, and 88.1%, respectively. Conclusions Arrested heart-totally endoscopic coronary artery bypass grafting shows excellent clinical long-term results with a left internal mammary artery patency rate comparable with conventional coronary artery bypass graft at 10 years after surgery.

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“…For the timeframe of one to 5 years postoperatively, survival rates are reported to be over 90% in all studies. One study even reports 100% survival at 41 months (9). In another paper showing 93% survival at 5 years, all deaths on followup were non-cardiac in nature (4).…”

Section: Methodsmentioning

confidence: 99%

Long-term results after robotically assisted coronary bypass surgery

Bonatti

Ramahi²,

Hasan³

et al. 2016

Ann. Cardiothorac. Surg.

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Background: Robotically-assisted coronary bypass grafting (CABG) was introduced in 1998 and dedicated centers have continuously applied and developed this minimally invasive method of coronary bypass surgery.While short-term results are relatively well published, data on long-term outcome are limited. In this literature review, we assessed the outcomes after robotic CABG following the first postoperative year. Methods:We searched PubMed for articles containing the terms "robotic" or "robotically assisted" and "coronary bypass". A total of 11 papers contained long-term results. We specifically investigated survival, graft patency, freedom from angina and re-intervention, as well as freedom from major adverse cardiac and cerebrovascular events (MACCE).Results: Five-year survival after robotic CABG was consistently consistently greater than 90% and graft patency between 3 and 5 years was reported to be above 90%. Fifteen percent to 26% of patients reexperienced angina at 3 to 5 years postoperatively. Long-term freedom from re-intervention reached the range and the 5-year freedom from MACCE rate was approximately 75%.Conclusions: According to data in the literature, long-term results after CABG carried out with the assistance of a surgical robot appear to be in line with results achieved after conventional CABG.

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Robotic Total Arterial Off-Pump Coronary Artery Bypass Grafting: Seven-Year Single-Center Experience and Long-Term Follow-Up of Graft Patency

Cited by 43 publications

References 33 publications

A systematic review on robotic coronary artery bypass graft surgery

A systematic review on robotic coronary artery bypass graft surgery

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

Long-term results after robotically assisted coronary bypass surgery

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