COMPARATIVE STUDY OF SAME SITTING HYBRID CORONARY ARTERY REVASCULARIZATION VERSUS OFF-PUMP CORONARY ARTERY BYPASS IN MULTI-VESSEL CORONARY ARTERY DISEASE
| Autor: | Lukasz Kiljanek, Mubashir Mumtaz, Gouthami Boga, Christine McCarty, Murad Abdelsalam, William Bachinsky |
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| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Bypass grafting Robotic assisted medicine.medical_treatment Statistics as Topic Coronary Artery Bypass Off-Pump Coronary Artery Disease Coronary Angiography Sitting Revascularization Severity of Illness Index Coronary artery disease Internal medicine Humans Medicine Prospective Studies Multi vessel coronary artery disease Aged Off-pump coronary artery bypass business.industry Length of Stay Middle Aged medicine.disease Coronary Vessels medicine.anatomical_structure Patient Satisfaction Quality of Life Cardiology Female Cardiology and Cardiovascular Medicine business human activities Artery |
| Zdroj: | Journal of the American College of Cardiology. 59:E1454 |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/s0735-1097(12)61455-7 |
| Popis: | We compared the outcomes of same sitting robotic-assisted hybrid coronary artery revascularization (HCR) with off-pump coronary artery bypass grafting (OPCABG) in similar patients with multivessel coronary artery disease.HCR is a novel procedure in selected patients with multivessel coronary artery disease (CAD). Although there are some data on staged HCR, the data on same sitting HCR are limited.We conducted a prospective study comparing same sitting robotic-assisted HCR patients (n = 25) to a group of consecutive low to moderate risk OPCABG patients (n = 27) during the study period. HCR patients underwent robotic internal mammary artery takedown followed by OPCABG via minithoracotomy. After confirming graft patency, immediate percutaneous coronary intervention on the nonbypass arteries was performed. Comparative analyses were performed on in-hospital and 30 day outcomes.The baseline characteristics were similar for both groups including the severity of CAD (Syntax score 33.5+/-8.2 vs. 34.9+/-8.2, P = 0.556). Overall MACE was similar between both groups; however, the HCR group showed improved hospital outcomes with lower need for postoperative transfusions (12% vs. 67%, P0.001), and shorter length of hospital stay (5.1+/-2.8 vs. 8.2+/-5.4 days, P0.01). Despite lower postoperative costs, the HCR group had higher overall hospital costs due to higher procedural costs ($33,984 +/-$4,806 vs. $27,816+/-$11,172, P0.0001). Propensity model analysis showed similar findings. The HCR group showed improved quality of life measures with shorter time to return to work (5.3+/-3.0 vs. 8.2+/- 4.6 weeks, P = 0.01).Same sitting HCR appears to be feasible and may offer superior outcomes to standard OPCABG, further studies are warranted. |
| Databáze: | OpenAIRE |
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