Abstract：
UNASSIGNED: Robot-assisted minimally invasive direct coronary artery bypass (RA-MIDCAB) is an attractive strategy for coronary revascularization. Growing evidence supports the use of total arterial grafting in coronary surgery. We evaluated total arterial left-sided coronary revascularization with bilateral internal thoracic artery (BITA) using RA-MIDCAB and compared it with a propensity score-matched (PSM) off-pump CAB (OPCAB) surgery population.
UNASSIGNED: We retrospectively included all isolated OPCAB and RA-MIDCAB surgery using BITA without saphenous vein graft from January 1, 2015, to October 31, 2022. We analyzed all our RA-MIDCAB patients and performed PSM to compare them with our OPCAB population. Primary outcomes were major adverse cardiovascular and cerebrovascular events (MACCE) and mortality. Secondary outcomes were surgical parameters, length of hospital stay, and learning curve.
UNASSIGNED: We included 601 OPCAB and 77 RA-MIDCAB procedures, which resulted in 2 cohorts of 54 patients after PSM. Mortality and MACCE survival analysis showed no significant difference. There was less blood transfusion in the RA-MIDCAB (16.7%) compared with the OPCAB group (38.9%; P = 0.02). We observed fewer intensive care unit (ICU) admissions (24.1% vs 96.6%), shorter ICU stay (0.78 ± 1.7 vs 1.91 ± 1.01 days), and shorter hospital stay (6.78 ± 2.4 vs 8.01 ± 2.5 days) in the RA-MIDCAB versus OPCAB group (P < 0.01). Surgery time decreased from 400.0 ± 70.8 to 325.0 ± 38.0 min with more experience in RA-MIDCAB BITA harvesting (P < 0.01).
UNASSIGNED: This is a first publication of 77 consecutive RA-MIDCAB BITA harvesting for left coronary artery system revascularization. This technique is safe in terms of MACCE and mortality. Additional advantages are shorter length of hospital stay, fewer ICU admissions, and less blood transfusion.
UNASSIGNED: We retrospectively included all isolated OPCAB and RA-MIDCAB surgery using BITA without saphenous vein graft from January 1, 2015, to October 31, 2022. We analyzed all our RA-MIDCAB patients and performed PSM to compare them with our OPCAB population. Primary outcomes were major adverse cardiovascular and cerebrovascular events (MACCE) and mortality. Secondary outcomes were surgical parameters, length of hospital stay, and learning curve.
UNASSIGNED: We included 601 OPCAB and 77 RA-MIDCAB procedures, which resulted in 2 cohorts of 54 patients after PSM. Mortality and MACCE survival analysis showed no significant difference. There was less blood transfusion in the RA-MIDCAB (16.7%) compared with the OPCAB group (38.9%; P = 0.02). We observed fewer intensive care unit (ICU) admissions (24.1% vs 96.6%), shorter ICU stay (0.78 ± 1.7 vs 1.91 ± 1.01 days), and shorter hospital stay (6.78 ± 2.4 vs 8.01 ± 2.5 days) in the RA-MIDCAB versus OPCAB group (P < 0.01). Surgery time decreased from 400.0 ± 70.8 to 325.0 ± 38.0 min with more experience in RA-MIDCAB BITA harvesting (P < 0.01).
UNASSIGNED: This is a first publication of 77 consecutive RA-MIDCAB BITA harvesting for left coronary artery system revascularization. This technique is safe in terms of MACCE and mortality. Additional advantages are shorter length of hospital stay, fewer ICU admissions, and less blood transfusion.
摘要：
■机器人辅助的微创直接冠状动脉搭桥术（RA-MIDCAB）是冠状动脉血运重建的一种有吸引力的策略。越来越多的证据支持在冠状动脉手术中使用全动脉移植。我们使用RA-MIDCAB评估了双侧胸廓内动脉（BITA）的总动脉左侧冠状动脉血运重建，并将其与倾向评分匹配（PSM）非体外循环CAB（OPCAB）手术人群进行了比较。
■我们回顾性纳入了2015年1月1日至2022年10月31日使用BITA进行的所有孤立的OPCAB和RA-MIDCAB手术，而没有进行大隐静脉移植。我们分析了所有RA-MIDCAB患者，并进行了PSM，以将其与我们的OPCAB人群进行比较。主要结局是主要不良心脑血管事件（MACCE）和死亡率。次要结果是手术参数，住院时间,和学习曲线。
■我们包括601OPCAB和77RA-MIDCAB程序，这导致2个队列的54名患者PSM后。死亡率和MACCE生存分析显示无显著差异。与OPCAB组（38.9%；P=0.02）相比，RA-MIDCAB组的输血减少（16.7%）。我们观察到重症监护病房（ICU）入院人数减少（24.1%vs96.6%），ICU住院时间较短（0.78±1.7vs1.91±1.01天），RA-MIDCAB与OPCAB组的住院时间较短（6.78±2.4vs8.01±2.5天）（P<0.01）。手术时间从400.0±70.8降至325.0±38.0min，RA-MIDCABBITA采集经验更多（P<0.01）。
■这是用于左冠状动脉系统血运重建的77份连续RA-MIDCABBITA采集的第一份出版物。该技术在MACCE和死亡率方面是安全的。其他优点是住院时间短，ICU入院人数减少，减少输血。
■我们回顾性纳入了2015年1月1日至2022年10月31日使用BITA进行的所有孤立的OPCAB和RA-MIDCAB手术，而没有进行大隐静脉移植。我们分析了所有RA-MIDCAB患者，并进行了PSM，以将其与我们的OPCAB人群进行比较。主要结局是主要不良心脑血管事件（MACCE）和死亡率。次要结果是手术参数，住院时间,和学习曲线。
■我们包括601OPCAB和77RA-MIDCAB程序，这导致2个队列的54名患者PSM后。死亡率和MACCE生存分析显示无显著差异。与OPCAB组（38.9%；P=0.02）相比，RA-MIDCAB组的输血减少（16.7%）。我们观察到重症监护病房（ICU）入院人数减少（24.1%vs96.6%），ICU住院时间较短（0.78±1.7vs1.91±1.01天），RA-MIDCAB与OPCAB组的住院时间较短（6.78±2.4vs8.01±2.5天）（P<0.01）。手术时间从400.0±70.8降至325.0±38.0min，RA-MIDCABBITA采集经验更多（P<0.01）。
■这是用于左冠状动脉系统血运重建的77份连续RA-MIDCABBITA采集的第一份出版物。该技术在MACCE和死亡率方面是安全的。其他优点是住院时间短，ICU入院人数减少，减少输血。
