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Midterm Clinical Outcomes of Robotic-Assisted Reverse Hybrid Coronary Revascularization: A Single-Center Experience
Aleksander Dokollari1, Marco Gemelli2, Serge Sicouri3
1Departments of Cardiac Surgery, Lankenau Heart Institute, Lankenau Medical Center, Main Line Health, Wynnewood, Pennsylvania; Cardiac Surgery Department, St. Boniface Hospital, University of Manitoba, Winnipeg, Manitoba, Canada.
Robotic-assisted reverse hybrid coronary revascularization (HCR) shows safe and effective midterm clinical outcomes for multivessel coronary artery disease. This procedure combines minimally invasive techniques with excellent results, offering a viable treatment option.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Cardiac Surgery
- Interventional Cardiology
Background:
- Robotic-assisted reverse hybrid coronary revascularization (HCR) outcomes require further analysis.
- Multivessel coronary artery disease necessitates effective revascularization strategies.
Purpose of the Study:
- To evaluate the midterm clinical outcomes of robotic-assisted reverse HCR.
- To assess the safety and efficacy of this hybrid approach for coronary artery disease.
Main Methods:
- A single-center study analyzed 285 patients undergoing robotic-assisted reverse HCR between 2005 and 2021.
- The procedure involved percutaneous coronary intervention (PCI) followed by robotic-assisted left internal thoracic artery (LITA) harvesting and LITA-to-LAD anastomosis.
- Dual antiplatelet therapy was maintained throughout the perioperative period.
Main Results:
- Midterm follow-up (mean 4.2 years) showed low rates of stroke (0.7%) and reoperation for bleeding (2.4%).
- Major adverse cardiovascular and cerebrovascular events occurred in 35.9% of patients.
- All-cause mortality was 10.9%, with myocardial infarction in 5.9% and repeat interventions in 17.5%.
Conclusions:
- Robotic-assisted reverse HCR demonstrates effective and safe midterm clinical outcomes for treating multivessel coronary artery disease.
- This hybrid approach offers a valuable option for patients requiring complex coronary revascularization.
