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Hybrid Coronary Revascularization by Endoscopic Robotic Coronary Artery Bypass Grafting on Beating Heart and Stent Placement
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| 09.03.2009, 15:31 |
Background. Hybrid revascularization has been used in
minimally invasive coronary artery bypass grafting and
percutaneous coronary intervention for multivessel coronary
artery disease (CAD). Very few endoscopic robotic
coronary bypasses on the beating heart have been reported.
The aim of this study was to assess hybrid
revascularization by endoscopic robotic coronary artery
bypass on the beating heart with percutaneous coronary
intervention in a staged approach.
Methods. Forty-two patients underwent selective robotic
coronary artery bypass grafting on the beating
heart. Ten patients with right coronary artery or circumflex
coronary stenosis underwent stent placement after
robotic left internal mammary artery (LIMA) anastomosis
to the left anterior descending (LAD) artery surgery in
a separate session. The average age of the patients was
62.3 12.1 years old. Coronary arteriography showed
significant stenosis or total occlusion of the LAD in all
patients and significant stenosis in the right coronary or
circumflex arteries. The LIMA was harvested by the da
Vinci S robotic surgical system (Intuitive Surgical,
Sunnyvale, CA) and manually anastomosed to the LAD
off-pump in 6 patients, and by totally endoscopic bypass
on the beating heart in 4 patients. Percutaneous coronary
intervention with placement of a stent to stenotic non-
LAD targets was performed 4 to 5 days after operation.
All LIMA-LAD grafts were assessed angiographically.
Results. All 10 patients had off-pump robotic bypass
surgery and stent placement using a staged approach
without complications.
Conclusions. Our preliminary study shows that hybrid
coronary revascularization by endoscopic robotic coronary
artery bypass grafting on a beating heart and subsequent
stent placement is a feasible integrated approach
for patients with multivessel CAD.
(Ann Thorac Surg 2009;87:737– 41)
© 2009 by The Society of Thoracic Surgeons
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| Категория: Статьи | Добавил: nbylova
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