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Robotic-enhanced coronary surgery in octogenarians.

Apostolos Roubelakis1, Filip Casselman2, Johan van der Merwe2

  • 1Department of Surgery, Division of Cardiac Surgery , St. Michael's Hospital, University of Toronto , Toronto , Canada.

Interactive Cardiovascular and Thoracic Surgery
|December 30, 2016
PubMed
Summary

Robotic-enhanced minimally invasive direct coronary artery bypass grafting surgery (RE-MIDCAB) is safe for octogenarians. This procedure shows feasible and acceptable mid-term results in elderly patients.

Keywords:
Coronary diseaseMinimal invasive surgeryOctogenarian

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Area of Science:

  • Cardiovascular Surgery
  • Robotic Surgery
  • Geriatric Medicine

Background:

  • Minimally invasive direct coronary artery bypass grafting (MIDCAB) offers advantages over traditional sternotomy.
  • Robotic assistance enhances precision in complex cardiac procedures.
  • Evaluating surgical outcomes in elderly populations is crucial due to increased comorbidities.

Purpose of the Study:

  • To assess the feasibility and outcomes of robotic-enhanced minimally invasive direct coronary artery bypass grafting (RE-MIDCAB) in octogenarians.
  • To present the surgical experience and results of RE-MIDCAB in elderly patients.

Main Methods:

  • Retrospective analysis of 44 octogenarian patients (mean age 82.9 years) undergoing RE-MIDCAB between 2002 and 2015.
  • Assessment of logistic EuroSCORE, patient demographics, and medical history.
  • Inclusion of hybrid revascularization cases combining RE-MIDCAB with percutaneous coronary intervention (PCI).

Main Results:

  • All RE-MIDCAB and hybrid PCI procedures were completed successfully.
  • Mean intensive care unit (ICU) and hospital stays were 1.6 and 10.9 days, respectively.
  • In-hospital mortality was 2.3% (1 patient), with a 9.1% rate of repeat revascularization and 25.6% follow-up mortality.

Conclusions:

  • RE-MIDCAB is a feasible and safe surgical option for octogenarian patients.
  • The procedure demonstrates acceptable mid-term results in this frail elderly population.
  • Robotic assistance facilitates complex coronary artery bypass grafting in older individuals.