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Updated: Apr 6, 2026
Author Spotlight: Enhancing Coronary Artery Revascularization
Published on: September 15, 2023
Robot-assisted Hybrid Coronary Revascularisation: Systematic Review
Nelson Wang1, Jessie J Zhou2, Steven Phan1
1Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
Insights
Robotic-assisted hybrid coronary revascularisation shows promising results for multi-vessel coronary artery disease, with low complication rates. Further randomized studies are needed to establish its role in standard cardiac interventions.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Robotic Surgery
Background:
- Hybrid coronary revascularisation (HCR) integrates surgical bypass grafting for the left anterior descending (LAD) artery with percutaneous coronary intervention (PCI) for other coronary arteries in multi-vessel disease.
- Robotic assistance in HCR is an evolving approach.
Purpose of the Study:
- To systematically review and assess evidence on robotic-assisted HCR.
- To explore the potential benefits and drawbacks of this technique.
Main Methods:
- A comprehensive literature search was conducted across six electronic databases.
- Eight studies were included for qualitative and pooled quantitative analysis.
Main Results:
- No in-hospital deaths were reported.
- Pooled rates included myocardial infarction (1.2%), stroke (0.8%), freedom from reintervention (92.5%), and freedom from angina (92.9%).
- Left internal thoracic artery (LITA) patency was high (89-100%), with hospital stays ranging from 4-8.1 days.
Conclusions:
- Robotic-assisted HCR demonstrates potentially acceptable mortality and complication rates in carefully selected patients.
- The technique shows promise but requires further comparative and randomized studies due to evidence heterogeneity and lack of long-term data.
Background:
Hybrid coronary revascularisation (HCR) for multi-vessel coronary artery disease combines surgical bypass grafting for the left anterior descending (LAD) coronary artery and percutaneous coronary intervention (PCI) for non-LAD coronary arteries. The present systematic review was conducted to assess the available evidence on robotic-assisted HCR and explore the potential advantages and disadvantages it proposes.
Methods:
A comprehensive search from six electronic databases was performed for studies reporting outcomes for robotic-assisted hybrid coronary revascularisation. Eight studies were identified from six electronic databases amenable for qualitative assessment and pooled quantitative analysis.
Results:
There were no in-hospital deaths reported. Pooled myocardial infarction rates was 1.2% (range 0-3.7%), pooled strokes was 0.8% (range: 0-1.7%), freedom from reintervention was 92.5% (range 70.4-100%), and freedom from angina was 92.9% (range 74.3-100%). LITA patency ranged from 89-100%, while hospital stay ranged from 4-8.1 days.
Conclusions:
The current data suggests potentially acceptable mortality and complication rates, when patients are carefully selected and operated on by expert cardiovascular teams. However, due to the heterogeneous nature of the evidence and lack of long-term outcomes, this promising technique warrants future comparative and randomised studies before becoming a part of mainstay coronary interventions.
