Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Balkhy, Husam H., Nisivaco, Sarah, Torregrossa, Gianluca, Kitahara, Hiroto, Patel, Brooke, Grady, Kaitlin, Coleman, Charocka
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
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
_version_ 1784727009530740736
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
work_keys_str_mv AT balkhyhusamh multispectrumroboticcardiacsurgeryearlyoutcomes
AT nisivacosarah multispectrumroboticcardiacsurgeryearlyoutcomes
AT torregrossagianluca multispectrumroboticcardiacsurgeryearlyoutcomes
AT kitaharahiroto multispectrumroboticcardiacsurgeryearlyoutcomes
AT patelbrooke multispectrumroboticcardiacsurgeryearlyoutcomes
AT gradykaitlin multispectrumroboticcardiacsurgeryearlyoutcomes
AT colemancharocka multispectrumroboticcardiacsurgeryearlyoutcomes