Robotic Coronary Revascularization is Feasible and Safe: 10-year Single-Center Experience

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Cardiac Surgery
• Robotic Surgery

Background:

• Coronary artery bypass grafting (CABG) is a standard treatment for coronary artery disease.
• Minimally invasive techniques aim to reduce surgical trauma and improve recovery.
• Robotic assistance enhances precision and dexterity in complex cardiac procedures.

Purpose of the Study:

• To investigate the outcomes of robotic surgical coronary revascularization.
• To compare total endoscopic coronary artery bypass (TECAB) and robotic-assisted minimally invasive direct coronary artery bypass (RA-MIDCAB).

Main Methods:

• Retrospective single-center study of 71 patients undergoing LIMA-to-LAD bypass using the da Vinci robotic system (2009-2020).
• Procedures included TECAB (robotic harvest and anastomosis) and RA-MIDCAB (robotic harvest, direct vision anastomosis).
• Data collected included preoperative, intraoperative, and postoperative outcomes, complications, and 3-month follow-up.

Main Results:

• The majority of patients were male (90.14%) with a mean age of 31-70 years.
• TECAB was performed in 66.2% of patients; 73.2% of procedures were completed as planned.
• Low rates of complications (bleeding 2.8%, infection 4.29%) and 30-day mortality (2.8%) were observed, with a median hospital stay of 5 days.

Conclusions:

• Robotic coronary revascularization is safe and feasible in selected patients, particularly those with single-vessel disease.
• Successful implementation requires specialized centers and surgeons experienced in robotic cardiac surgery.
• Long-term outcomes and broader applicability warrant further investigation.