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Multi-spectrum robotic cardiac surgery: Early outcomes
OBJECTIVE: The robotic cardiac surgery program at our current institution began in 2013 with an experienced and dedicated team. This review analyzes early outcomes in the first 1103 patients. METHODS: We reviewed all robotic procedures between July 2013 and February 2021. Primary outcomes were morta...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9195635/ https://www.ncbi.nlm.nih.gov/pubmed/35711214 http://dx.doi.org/10.1016/j.xjtc.2021.12.018 |
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author | Balkhy, Husam H. Nisivaco, Sarah Torregrossa, Gianluca Kitahara, Hiroto Patel, Brooke Grady, Kaitlin Coleman, Charocka |
author_facet | Balkhy, Husam H. Nisivaco, Sarah Torregrossa, Gianluca Kitahara, Hiroto Patel, Brooke Grady, Kaitlin Coleman, Charocka |
author_sort | Balkhy, Husam H. |
collection | PubMed |
description | OBJECTIVE: The robotic cardiac surgery program at our current institution began in 2013 with an experienced and dedicated team. This review analyzes early outcomes in the first 1103 patients. METHODS: We reviewed all robotic procedures between July 2013 and February 2021. Primary outcomes were mortality and perioperative morbidity. Our robotic approach is totally endoscopic for all cases: off-pump for coronary and epicardial procedures, and on-pump with the endoballoon for mitral valve and other intracardiac procedures. RESULTS: There were 1103 robotic-assisted cardiac surgeries over 7 years. A total of 585 (53%) were off-pump totally endoscopic coronary artery bypasses, 399 (36%) intracardiac cases (including isolated and concomitant mitral valve procedures, isolated tricuspid valve repair, CryoMaze, atrial or ventricular septal defect repair, benign cardiac tumor, septal myectomy, partial anomalous pulmonary venous drainage, and aortic valve replacement); 80 (7%) epicardial electrophysiology-related procedures (epicardial atrial fibrillation ablation, left atrial appendage ligation, lead placement, and ventricular tachycardia ablation); and 39 (4%) other epicardial procedures (pericardiectomy, unroofing myocardial bridge). Mortality was 1.2% (observed/expected ratio, 0.7). In the totally endoscopic coronary artery bypass and intracardiac groups, mortality was 1.0% (observed/expected, 0.6) and 1.5% (observed/expected, 0.87), respectively. There were 8 conversions to sternotomy (0.7%) and 24 (2.2%) take-backs for bleeding. Mean hospital and intensive care unit lengths of stay were 2.74 ± 1.26 days and 1.28 ± 0.57 days, respectively. CONCLUSIONS: This experience demonstrates that a robotic endoscopic approach can safely be used in a multitude of cardiac surgical procedures both on- and off-pump with excellent early outcomes. An experienced surgeon and team are necessary. Longer-term follow-up is warranted. |
format | Online Article Text |
id | pubmed-9195635 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-91956352022-06-15 Multi-spectrum robotic cardiac surgery: Early outcomes Balkhy, Husam H. Nisivaco, Sarah Torregrossa, Gianluca Kitahara, Hiroto Patel, Brooke Grady, Kaitlin Coleman, Charocka JTCVS Tech Adult: Coronary OBJECTIVE: The robotic cardiac surgery program at our current institution began in 2013 with an experienced and dedicated team. This review analyzes early outcomes in the first 1103 patients. METHODS: We reviewed all robotic procedures between July 2013 and February 2021. Primary outcomes were mortality and perioperative morbidity. Our robotic approach is totally endoscopic for all cases: off-pump for coronary and epicardial procedures, and on-pump with the endoballoon for mitral valve and other intracardiac procedures. RESULTS: There were 1103 robotic-assisted cardiac surgeries over 7 years. A total of 585 (53%) were off-pump totally endoscopic coronary artery bypasses, 399 (36%) intracardiac cases (including isolated and concomitant mitral valve procedures, isolated tricuspid valve repair, CryoMaze, atrial or ventricular septal defect repair, benign cardiac tumor, septal myectomy, partial anomalous pulmonary venous drainage, and aortic valve replacement); 80 (7%) epicardial electrophysiology-related procedures (epicardial atrial fibrillation ablation, left atrial appendage ligation, lead placement, and ventricular tachycardia ablation); and 39 (4%) other epicardial procedures (pericardiectomy, unroofing myocardial bridge). Mortality was 1.2% (observed/expected ratio, 0.7). In the totally endoscopic coronary artery bypass and intracardiac groups, mortality was 1.0% (observed/expected, 0.6) and 1.5% (observed/expected, 0.87), respectively. There were 8 conversions to sternotomy (0.7%) and 24 (2.2%) take-backs for bleeding. Mean hospital and intensive care unit lengths of stay were 2.74 ± 1.26 days and 1.28 ± 0.57 days, respectively. CONCLUSIONS: This experience demonstrates that a robotic endoscopic approach can safely be used in a multitude of cardiac surgical procedures both on- and off-pump with excellent early outcomes. An experienced surgeon and team are necessary. Longer-term follow-up is warranted. Elsevier 2022-02-19 /pmc/articles/PMC9195635/ /pubmed/35711214 http://dx.doi.org/10.1016/j.xjtc.2021.12.018 Text en © 2022 The Author(s) https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Adult: Coronary Balkhy, Husam H. Nisivaco, Sarah Torregrossa, Gianluca Kitahara, Hiroto Patel, Brooke Grady, Kaitlin Coleman, Charocka Multi-spectrum robotic cardiac surgery: Early outcomes |
title | Multi-spectrum robotic cardiac surgery: Early outcomes |
title_full | Multi-spectrum robotic cardiac surgery: Early outcomes |
title_fullStr | Multi-spectrum robotic cardiac surgery: Early outcomes |
title_full_unstemmed | Multi-spectrum robotic cardiac surgery: Early outcomes |
title_short | Multi-spectrum robotic cardiac surgery: Early outcomes |
title_sort | multi-spectrum robotic cardiac surgery: early outcomes |
topic | Adult: Coronary |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9195635/ https://www.ncbi.nlm.nih.gov/pubmed/35711214 http://dx.doi.org/10.1016/j.xjtc.2021.12.018 |
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