Abstract
Currently, robotic-assisted coronary artery bypass grafting (RACABG) is a feasible choice for myocardial revascularization. Acceptable outcomes have been reported for RACABG with single target vessels; however, the long-term benefits of multivessel RACABG with composite arterial grafts have rarely been studied. Therefore, our study investigated the long-term results of multivessel RACABG with composite arterial grafts by reviewing the clinical data of patients from Taichung Veterans General Hospital. From December 2005 to June 2015, 562 patients underwent robotic-assisted robotic minimally invasive direct coronary bypass (MIDCAB) at Taichung Veterans General Hospital. Two major composite arterial graft configurations (i.e., inverted T-graft and Y-graft) were used. Data regarding the short-term and long-term outcomes of robotic-assisted MIDCAB were obtained from the medical records. For data regarding long-term outcomes of the patients not followed up at our institution, telephone interviews were conducted in June 2019. The in-hospital mortality rate and complication rate were 2.5% and 17.6%, respectively. We completed the follow-up for 486 patients (86.4%), and postoperative coronary imaging-based evaluation performed for 157 patients. The 5-year and 10-year survival rates were 82.7% and 65.2%, respectively. The 5-year and 10-year major adverse cardiac and cerebral events-free survival rates were 86.9% and 70.9%, respectively. The 5-year patency rate of various coronary anastomoses was 85.1–100%. Our study revealed that multivessel robotic-assisted MIDCAB with composite arterial grafts provided acceptable long-term outcomes, irrespective of the composite graft configuration.
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Acknowledgements
The authors would like to thank the nurse practitioners of the Department of Cardiovascular Surgery at the Taichung Veterans General Hospital for their efforts in collecting long-term follow-up data and conducting telephone interviews.
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H-JW contributed to the study design and conducted the long-term follow-up program. All patients were operated by YC and C-LY. The clinical data collection and analysis were performed by C-LY and C-YL. The first draft of the manuscript was written by C-YL, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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The protocol of the study was reviewed and approved by the institutional review board of Taichung Veterans General Hospital as a minimal-risk retrospective study (approval no. CE20227A).
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The institutional review board of Taichung Veterans General Hospital regarded the study as a minimal-risk retrospective study and a waiver of informed consent was obtained.
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Lo, CY., Yu, CL., Chang, Y. et al. Long-term results of robotic-assisted coronary artery bypass grafting with composite arterial grafts for multiple coronary anastomoses: 10-year experience. J Robotic Surg 17, 63–71 (2023). https://doi.org/10.1007/s11701-022-01391-z
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DOI: https://doi.org/10.1007/s11701-022-01391-z