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J. Clin. Med. 2019, 8(4), 502; https://doi.org/10.3390/jcm8040502

Outcome of Robot-Assisted Bilateral Internal Mammary Artery Grafting via Left Pleura in Coronary Bypass Surgery

1
Cardiovascular Center, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan
2
Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
3
Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan
4
Yuh-Ing Junior College of Health Care & Management, Kaohsiung 821, Taiwan
5
School of Medicine, National Yang-Ming University, Taipei 112, Taiwan
6
Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan
7
Department of Cardiology, Kaohsiung Municipal United Hospital, Kaohsiung 804, Taiwan
8
Department of Biological Sciences, National Sun Yat-Sen University, Kaohsiung 804, Taiwan
*
Author to whom correspondence should be addressed.
Received: 25 February 2019 / Revised: 22 March 2019 / Accepted: 10 April 2019 / Published: 12 April 2019
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Abstract

Studies are extremely limited for the investigation of the clinical outcome of da Vinci robot-assisted bilateral internal mammary artery (BIMA) grafting in coronary artery bypass grafting (CABG) surgery. This study aimed to explore the short-term outcome of da Vinci robot-assisted BIMA grafting through the left pleural space. Relevant data were collected from patients with multi-vessel coronary artery disease receiving two kinds of CABG: a group of patients receiving da Vinci robot-assisted CABG with BIMA grafting, and another group of patients receiving sternotomy CABG with BIMA grafting. Primary endpoints, which included cardiovascular and renal endpoints, were analyzed between the groups using the chi-square test, analysis of variance test, and Kaplan–Meier analysis. Compared with the conventional group (n = 22), the robotic group (n = 22) had a significantly longer operation time (12.7 ± 1.7 vs. 8.5 ± 1.5 hours; p < 0.01) and a marginally lower mean of serum creatinine at baseline (1.2 ± 0.3 vs. 2.0 ± 1.7 mg/dL; p = 0.04). Primary endpoints (5, 22.7% vs. 12, 54.5%; p = 0.03) and renal endpoints (1, 4.5% vs. 7, 31.8%; p = 0.02) at six months were significantly reduced in the robotic group compared with the conventional group. There were no differences in cardiovascular endpoints at six months between the groups (1, 4.5% vs. 0; p = 1.00). The data showed that da Vinci robot-assisted BIMA grafting was safe, with equal cardiovascular events and lowered renal events at six months, as compared to conventional sternotomy BIMA grafting, despite the longer procedure time. The short-term study suggests that da Vinci robot-assisted BIMA grafting may be considered a favorable surgical option for patients with severe coronary artery disease. View Full-Text
Keywords: bilateral internal mammary artery; coronary artery disease; coronary artery bypass grafting; da Vinci; sternotomy; outcome bilateral internal mammary artery; coronary artery disease; coronary artery bypass grafting; da Vinci; sternotomy; outcome
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Wu, C.-J.; Chen, H.-H.; Cheng, P.-W.; Lu, W.-H.; Tseng, C.-J.; Lai, C.-C. Outcome of Robot-Assisted Bilateral Internal Mammary Artery Grafting via Left Pleura in Coronary Bypass Surgery. J. Clin. Med. 2019, 8, 502.

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