Francis D. Ferdinand, Francis P. Sutter, Candace Trace, Mary Ann C. Wertan, Scott M. Goldman.
Lankenau Hospital Div of Thor & CV Surgery, Wynewood, PA, USA.
OBJECTIVE:
A direct approach to coronary revascularization utilizing robotic assistance and direct anastamosis on a beating heart takes advantage of facilatating technology and traditional methods. We studied this approach in a consecutive series of patients in our robotic revascularization program.
METHODS:
Between May 2005 and August 2007, 162 patients underwent robotically assisted OP-CAB via a 4 cm muscle sparing, non rib spreading incision with 2 port sites. All data was prospectively entered into our STS compatable database.
RESULTS:
Mean age was 66.2±11 yrs, 66.7% were male, and 41.4% were treated diabetics. 77.8% had either LM, Single or Double vessel disease and 95.7% underwent OP-CAB X 1 or 2 for an average of 1.37 distal anastamoses with 15.4% receiving LIMA and RIMA grafts. 91.4% were extubated in the OR. The STS Predicted Risk was 2.44% and the Observed 30d Mortality was 0.62%. Of the total group, 59 (36.4%) had a hybrid procedure (CABG & PCI) with a STS Risk of 3.37% and Observed 30d Mortality of 1.7%. There were no reoperations for graft failure.
CONCLUSIONS:
Minimally invasive robotically assisted OP-CAB is safe, maximizes the advntages of enableing technology and facilatates a strategy of primary revascularization with selective use of hybrid procedures.
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