The midterm outcome and MACE of robotically enhanced grafting of left anterior descending artery with left internal mammary artery

Journal of Cardiothoracic Surgery

Thanos Athanasiou³  Espeed Khoshbin²  Roberto Casula¹ 

[1] Department of Cardiothoracic Surgery, Hammersmith Hospital, Shepherds Bush, London, England W12 0HS, UK;Espeed Khoshbin, University Hospital of Central Manchester, Oxford Road, Manchester M13 9WL, UK;The Department of Biosurgery and Surgical Technology, Imperial College London, 10th Floor, Queen Elizabeth the Queen Mother (QEQM) Building St Mary’s Hospital Campus Praed Street, London W2 1NY, UK

关键词: MACE;    Coronary artery bypass grafting;    Robotic;    Da Vinci;   

Others  :  811921
DOI  :  10.1186/1749-8090-9-19

 received in 2013-08-14, accepted in 2013-12-26,  发布年份 2014

【 摘 要 】

Background

We assessed the midterm outcome and the incidence of major adverse cardiovascular events in UK’s largest Da Vinci assisted robotic coronary revascularisation cohort. This study was set up at the Imperial College NHS Trust, St. Mary’s Hospital, London, United Kingdom.

Method

Benchmarking approach through retrospective audit of the regional outcomes against standards in the published literature. Data was collected from the patient’s records, communication with the primary care physicians and the national strategic tracing service. The results were compared with the published literature. Patients who underwent robotic assisted coronary revascularisation were included. Other robotic procedures or minimally invasive revascularisation without the use of the Da Vinci robot were excluded. The main outcome measure was the midterm survival up to five years and the incidence of major adverse cardiovascular events (MACE) up to three years.

Results

Since April 2002, one hundred consecutive patients underwent either off pump robotic assisted single vessel small thoracotomy (SVST, n = 88), or off pump total endoscopic coronary artery bypass grafting (TCAB, n = 12). All patients were operated on by the same primary surgeon but different assisting surgeons. All patients received a left internal mammary arterial (LIMA) graft as planned. The primary outcome of total one month and three years MACE and up to five year survival was 0, 9 and 96% respectively.

Conclusions

The procedural success rates in terms of morbidity and mortality up to five years are compatible to the outcomes observed outside the United Kingdom. These results are not inferior to that of conventional off pump single vessel coronary surgery or percutaneous coronary intervention to the LAD.

【 授权许可】

   
2014 Casula et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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