Related Experiment Video
Updated: Jun 25, 2026
Evaluation of a Novel Laser-assisted Coronary Anastomotic Connector - the Trinity Clip - in a Porcine Off-pump Bypass Model
Published on: November 24, 2014
Robot-Assisted Coronary Artery Bypass Versus Percutaneous Coronary Intervention in Patients With Coronary Artery
Mohamed Doma1, Edmundo Damiani Bertoli2, Gustavo Rovari3
1Cardiovascular Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Insights
Robot-assisted coronary artery bypass grafting (R-CABG) shows fewer instances of target vessel revascularization and myocardial infarction compared to percutaneous coronary intervention (PCI) for coronary artery disease (CAD). Survival rates were similar between the two procedures.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
Background:
- Coronary artery disease (CAD) management involves conventional coronary artery bypass grafting (CABG), robot-assisted CABG (R-CABG), and percutaneous coronary intervention (PCI).
- R-CABG and PCI offer less invasive alternatives to traditional CABG.
- Limited comparative outcome data exists between R-CABG and PCI.
Purpose of the Study:
- To compare the clinical outcomes of R-CABG versus PCI in patients with CAD.
- To evaluate differences in target vessel revascularization (TVR), myocardial infarction (MI), and mortality.
Main Methods:
- Systematic literature search for studies comparing R-CABG and PCI.
- Random-effects models to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs).
- Stratification by disease complexity (left main/multivessel vs. isolated LAD).
- Reconstruction of individual participant data (IPD) from Kaplan-Meier curves for survival analyses (hazard ratios).
Main Results:
- Analysis of six retrospective studies with 1,896 patients.
- R-CABG was associated with significantly lower odds of TVR (OR=0.50) and MI (OR=0.44) compared to PCI.
- No significant difference in all-cause mortality between R-CABG and PCI.
- In left main/multivessel disease, R-CABG reduced TVR and MI.
- For LAD lesions, R-CABG significantly lowered MI (OR=0.18) and major adverse cardiovascular events (MACE; OR=0.51).
- IPD analysis showed improved freedom from reintervention (HR=0.31) and MACE (HR=0.24) with R-CABG.
Conclusions:
- R-CABG demonstrates superior outcomes in reducing TVR and MI compared to PCI for CAD patients.
- No significant difference in all-cause mortality was observed between R-CABG and PCI.
- R-CABG may be a favorable option for specific CAD patient populations.
Objective:
As alternatives to conventional coronary artery bypass grafting (CABG), robot-assisted CABG (R-CABG) and percutaneous coronary intervention (PCI) offer less invasive treatments for coronary artery disease (CAD). However, data comparing outcomes of R-CABG versus PCI are limited.
Methods:
Databases were systematically searched for studies comparing R-CABG versus PCI. Random-effects models were used to calculate pooled odds ratios (ORs) with 95% confidence intervals (CIs), both overall and stratified by left main or multivessel (LM+MV) or isolated left anterior descending artery (LAD) disease. Kaplan-Meier curves were digitally extracted to reconstruct individual participant data (IPD), from which hazard ratios (HRs) were estimated for survival analyses.
Results:
Six retrospective studies, including 1,896 patients (R-CABG: 894, 47.1%), were analyzed. The mean age was 63.8 ± 11.3 years, and 78.7% were male patients. Follow-up ranged from 2 to 8 years. Overall, R-CABG was associated with a lower odds of target vessel revascularization (TVR; OR = 0.50, 95% CI: 0.27 to 0.93, P = 0.03) and myocardial infarction (MI; OR = 0.44, 95% CI: 0.26 to 0.76, P < 0.01), with no significant difference in all-cause mortality. Among patients with LM+MV disease, R-CABG reduced TVR and MI. In LAD lesions, R-CABG significantly lowered the likelihood of MI (OR = 0.18, 95% CI: 0.04 to 0.71) as well as major adverse cardiovascular events (MACE; OR = 0.51, 95% CI: 0.28 to 0.93). Time-to-event analysis from reconstructed IPD demonstrated significantly improved freedom from reintervention (HR = 0.31, 95% CI: 0.16 to 0.60) and MACE (HR = 0.24, 95% CI: 0.15 to 0.60) with R-CABG, whereas no significant difference was found for all-cause mortality.
Conclusions:
R-CABG was associated with less TVR and MI compared with PCI in CAD patients, with no difference in all-cause mortality.
Related Concept Videos
01:27Coronary Artery Disease V: Interprofessional Care
01:27Peripheral Artery Disease III: Interprofessional Care