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Updated: May 6, 2026
Robot-Assisted Kidney Transplantation
Published on: July 19, 2021
Early clinical and angiographic outcomes after robotic-assisted coronary artery bypass surgery
Michael E Halkos1, Henry A Liberman2, Chandan Devireddy2
1The Clinical Research Unit, Division of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, Ga.
Insights
Robotic-assisted coronary artery bypass grafting offers a safe and effective alternative for coronary artery disease patients. This minimally invasive approach shows comparable short-term clinical and angiographic results to traditional methods.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Surgery
- Robotic Surgery
Background:
- Coronary artery bypass grafting (CABG) is a standard treatment for coronary artery disease.
- Robotic-assisted CABG (RACABG) presents a minimally invasive alternative.
- Large-scale safety and efficacy data for RACABG are limited.
Purpose of the Study:
- To evaluate the safety and efficacy of robotic-assisted coronary artery bypass grafting.
- To assess short-term clinical and angiographic outcomes of RACABG.
- To establish RACABG as a viable alternative to traditional CABG.
Main Methods:
- A single-center study of 307 consecutive RACABG procedures performed between October 2009 and September 2012.
- Focus on isolated, off-pump, left internal thoracic artery to left anterior descending artery grafting via minithoracotomy.
- Hybrid coronary revascularization was planned in 51.8% of patients; 64.8% underwent pre-discharge angiography.
Main Results:
- Low 30-day mortality (1.3%), with low rates of postoperative myocardial infarction (1.6%) and stroke (0.3%).
- High graft patency rate (95.0%) confirmed by angiography.
- Conversion to sternotomy occurred in 5.2% of patients; 2.3% required reexploration for bleeding.
Conclusions:
- Robotic-assisted coronary artery bypass grafting is a safe and effective option for coronary artery disease.
- RACABG demonstrates comparable short-term clinical and angiographic outcomes to traditional CABG.
- This minimally invasive technique is a suitable alternative for selected patients.
Objective:
Robotic-assisted coronary artery bypass grafting has emerged as an alternative to traditional coronary artery bypass grafting or percutaneous intervention for patients with coronary artery disease. However, the safety and efficacy of this minimally invasive procedure have not been established in large series.
Methods:
From October 2009 to September 2012, 307 consecutive robotic-assisted coronary artery bypass grafting procedures were performed at a single US institution by 2 surgeons. Isolated, off-pump, left internal thoracic artery to left anterior descending coronary artery grafting was planned via a 3- to 4-cm non-rib-spreading minithoracotomy after robotic left internal thoracic artery harvest in all patients. Hybrid coronary revascularization was planned in 159 patients (51.8%). Of the 199 angiograms (64.8%) performed before discharge, 63 were performed as completion angiograms in a hybrid suite immediately after left internal thoracic artery-left anterior descending artery grafting.
Results:
Thirty-day mortality occurred in 4 patients (1.3%), conversion to sternotomy occurred in 16 patients (5.2%), postoperative myocardial infarction occurred in 5 patients (1.6%), and reexploration for bleeding occurred in 7 patients (2.3%). There was 1 (0.3%) postoperative stroke. For the 199 patients with follow-up angiography before discharge, the left internal thoracic artery was confirmed to be patent (<50% stenosis) in 189 patients (95.0%). Among the 10 patients with significant (≥50% stenosis) defects, 5 had graft occlusion or distal left anterior descending occlusion, 2 had poor flow distal to the anastomosis, and 3 had anastomotic lesions (≥50% stenosis). Among the 63 patients with intraoperative completion angiography, 5 patients underwent surgical graft revision, 3 patients underwent minithoracotomy, and 2 patients underwent conversion to sternotomy.
Conclusions:
Robotic-assisted coronary artery bypass grafting is an effective alternative to traditional coronary artery bypass grafting for patients with single or multivessel coronary artery disease, with comparable short-term clinical and angiographic results.
