A 7-year, single-center research and long term follow-up of graft patency of robotic total arterial off-pump coronary artery bypass grafting / 解放军医学杂志

ABSTRACT

Objective The aim of the study was to explore the long-term benefits of coronary artery bypass grafting (CABG). Methods From January 2007 to November 2014, 240 patients (187 males and 53 females, average age 59 years) received robotic off-pump CABG assisted with da Vinci Surgical System (Intuitive Surgical, USA) in our center. Totally endoscopic coronary artery bypass (totally robot-assisted TECAB, n=100) or mini-thoracotomy direct coronary artery bypass (free of internal mammary artery, IMA, by robot, MIDCAB, n=140) grafting was performed. Patients were followed-up regularly, and their graft patency was assessed every 6 months by coronary angiography or 64-multi-slide CT angiography. Results All the procedures were completed successfully without conversion to median sternotomy or cardiopulmonary bypass, there was no operative mortality. 237 unilateral IMA grafts (98.7%) and 3 bilateral IMA grafts (1.3%) were used. Hybrid revascularization of non-left anterior descending vessels was performed in 24 patients (10%). In the follow-up of 41.1±12.9 months, no death, stroke or myocardial infarction occurred. All grafts were patent before discharge. The IMA graft patency was 97.1% in TECAB and 96.4 % in MIDCAB over 3 years (up to 91 months) after surgery. Conclusions Robotic off-pump CABG using IMA grafts is a safe and effective surgery method in selected patients. The long-term outcome and patency of IMA grafts are excellent.