Original articlesCardiovascularRobotic Assisted Multivessel Minimally Invasive Direct Coronary Artery Bypass With Port-Access Stabilization and Cardiac Positioning: Paving the Way for Outpatient Coronary Surgery?
Section snippets
Patient Characteristics
From January to July 2003, 30 patients underwent off-pump multivessel MIDCAB at Lenox Hill Hospital.
Data Collection and Follow-Up
All the preoperative, intraoperative, and postoperative variables were collected in accordance with New York State cardiac surgery reporting system. Follow-up was done either by the referring cardiologist or in our institution depending on patient's convenience.
Patient selection criteria was as follows:
- 1
Good size coronary artery targets greater than 1.75-mm diameter without any diffuse disease
- 2
All
Preoperative Characteristics
All the preoperative characteristics of the patients are listed in Table 1.
Operative Details
Twenty-three patients (77%) had left anterior thoracotomy approach, whereas 7 patients (23%) had transabdominal approach. The average total operative timing was 7 hours 24 minutes (± 49 minutes), which included anesthesia time and time needed to extubate at the end of operation. The average robotic time was 1 hour 30 minutes (± 35 minutes), which included robotic preparation time as well as harvesting of bilateral IMAs.
Comment
The initial approach for limited-access coronary artery revascularization was an anterior exposure of the heart for grafting of mid to distal left anterior descending coronary artery with pedicle left IMA conduit 2, 3. Despite initial concerns about technical difficulties of the MIDCAB operation, it has become a more standardized procedure in hands of some experts with the advent of stabilization devices 2, 3, 12, 13, 14. However, anterior MIDCAB has been predominantly limited to single vessel
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