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Total arterial revascularization using robot assisted minimally invasive coronary artery bypass: an Indian experience

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Indian Journal of Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Objective

The aim of this study is to analyze the early outcomes of Total Arterial Revascularization using Robot Assisted Minimally Invasive Coronary Artery Bypass at our center between June 2019 and January 2023.

Methods

This is a retrospective analysis of 195 patients who underwent Total Arterial Coronary Revascularization through Robot Assisted Minimally Invasive Coronary Artery Bypass procedure (RA-CABG) during the period of June 2019 and January 2023 in a quaternary care center in India. Primary outcome variables were in-hospital and 30-day mortality. Secondary outcome variables included duration of surgery, length of intensive care unit (ICU) stay, in-hospital stay and perioperative morbidity. The entire patient population was divided into two groups for a subgroup analysis based on when the surgery was conducted i.e. the years since the robotic program was begun at our institution with 81 patients in group I (2019–2021), and 114 patients in group II (2022–2023).

Results

195 patients [88.7% male, mean age of 61.34 ± 9.58 years] underwent RA-CABG during the 5-year period (2019–2023) by a single experienced surgeon and his team. Conversion to larger thoracic incisions was required in 5 cases (2.59%). In-hospital and 30-day mortality was 1.02% each. The average length of ICU stay and hospital stay were 2.82 ± 1.17 days and 5.84 ± 1.71 days respectively. The duration of ICU stay correlated with the number of internal mammary artery grafts procured (p = 0.0022). Median duration of follow-up was 11 months. Overall mortality was 3.62% and cardiac related mortality was 2.07%, and 5 patients (2.59%) underwent percutaneous coronary intervention. Results of the sub-group analysis revealed a statistically significant difference between the groups in terms of number of internal mammary artery grafts procured (p = 0.010), need for transfusions (p = 0.00031), ICU stay (p = 0.0005) and in-hospital stay (p = 0.0006).

Conclusions

Total Arterial Coronary Revascularization through RA-CABG is a viable procedure in select patients. An experienced surgeon and team are required. Further studies in the form of randomized trials with long term follow-up are required to establish the overall utility, effectiveness and benefits to the patients.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Apollo Heart Institute, Apollo Hospitals, Greams Road, Chennai, 600006, India

    Meeranghani Mohamed Yusuf, Senguttovelu Gunasekaran, Dhamodaran Kaliyamoorthy & Aishwarya Mahesh Kumar

  2. Apollo Heart Institute, Indraprastha Apollo Hospital, Mathura Road, New Delhi, 110076, India

    Varun Bansal

  3. Department of Medical Services, Apollo Hospital, Greams Road, Chennai, India

    Aishwarya Mahesh Kumar

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  1. Meeranghani Mohamed Yusuf
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Contributions

Conceptualization, M.M.Y; methodology, M.M.Y, V.B.; validation, S.G. and D.K.; formal analysis, A.M.K.; data curation, M.M.Y, A.M.K; writing—original draft preparation, A.M.K.; writing—review and editing, A.M.K, V.B.; supervision, M.M.Y, S.G and D.K.; project administration, A.M.K. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Aishwarya Mahesh Kumar.

Ethics declarations

Institutional review board approval

The study was approved by the Institutional Review Board of Apollo Hospitals, Chennai (AMH-C-S-019/03-23).

Statement of human and animal rights

The study was conducted according to the guidelines of the Declaration of Helsinki.

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Individual patient consent was waived as the study was a de-identified retrospective study.

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Yusuf, M.M., Bansal, V., Gunasekaran, S. et al. Total arterial revascularization using robot assisted minimally invasive coronary artery bypass: an Indian experience. Indian J Thorac Cardiovasc Surg 40, 42–49 (2024). https://doi.org/10.1007/s12055-023-01593-6

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  • DOI: https://doi.org/10.1007/s12055-023-01593-6

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