Excellent long-term result 10 years after minimally invasive quadruple coronary artery bypass

Objective The primary objective was to investigate the long-term survival of patients who underwent single-vessel coronary revascularization with minimally invasive direct coronary artery bypass surgery with or without hybrid revascularization. The secondary outcome measures were repeat revascularization either by coronary artery bypass grafting or by percutaneous coronary intervention and the incidence of myocardial infarction or recurrent angina. Methods This is a retrospective study of prospectively collected data of patients who underwent minimally invasive direct coronary artery bypass procedure in our center between January 2001 and December 2015. Procedures were performed either through small left anterolateral thoracotomy or lower midline sternotomy. Results A total of 182 patients were identified: 100 underwent minimally invasive direct coronary artery bypass to the left anterior descending artery and 82 underwent hybrid revascularization (percutaneous coronary intervention to coronary arteries other than the left anterior descending artery along with minimally invasive direct coronary artery bypass to the left anterior descending artery). The mean ± SD age was 62 ± 10.1 years. Preoperatively 82% were male, and 72.5% patients had good left ventricular function. The median follow-up period was 10.9 years. There was no inhospital or 30-day mortality. The 10-year actuarial survival was 84.8%. Freedom from repeat revascularization was 98.9% at 1 year and 89.9% at 10 years. At follow-up, freedom from myocardial infarction was 96.7% whereas freedom from angina was 92.9%. Conclusions Within the limitations imposed by retrospective analyses, our study demonstrates excellent long-term outcome in patients undergoing minimally invasive direct coronary artery bypass with or without hybrid revascularization. For isolated left anterior descending artery disease minimally invasive direct coronary artery bypass should be considered, whereas hybrid revascularization (percutaneous coronary intervention and minimally invasive direct coronary artery bypass) should be considered for multivessel disease.

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Long-term clinical outcome after minimally invasive direct coronary artery bypass grafting via partial inferior reversed l-shaped sternotomy (PIRLS)

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0029-1191670 ◽

2009 ◽

Vol 56 (S 01) ◽

Author(s):

K Hakim ◽

I Friedrich ◽

O Kuss ◽

A Renner ◽

JF Gummert ◽

...

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Clinical Outcome ◽

Minimally Invasive ◽

Coronary Artery Bypass ◽

Artery Bypass ◽

Bypass Grafting ◽

Artery Bypass Grafting

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Long-term outcomes of percutaneous coronary intervention and minimally invasive direct coronary artery bypass (MIDCAB) in complex LAD lesion

Clinical and Experimental Surgery. Petrovsky journal ◽

10.33029/2308-1198-2021-9-3-74-81 ◽

2021 ◽

Vol 9 (3) ◽

pp. 74-81

Author(s):

G.V. Mardanyan ◽

◽

S.A. Abugov ◽

I.V. Zhbanov ◽

M.V. Puretskiy ◽

...

Keyword(s):

Percutaneous Coronary Intervention ◽

Coronary Artery ◽

Minimally Invasive ◽

Coronary Artery Bypass ◽

Artery Bypass ◽

Coronary Intervention ◽

Long Term Outcomes ◽

Percutaneous Coronary

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Graft Patency after Robotically Assisted Coronary Artery Bypass Surgery

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery ◽

10.1177/1556984519836896 ◽

2019 ◽

Vol 14 (2) ◽

pp. 117-123 ◽

Cited By ~ 6

Author(s):

Hiroto Kitahara ◽

Sarah Nisivaco ◽

Husam H. Balkhy

Keyword(s):

Coronary Artery ◽

Minimally Invasive ◽

Coronary Artery Bypass ◽

Coronary Artery Bypass Surgery ◽

Bypass Surgery ◽

Artery Bypass ◽

Coronary Bypass ◽

Graft Patency ◽

Robotic Assisted

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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