Does Body Mass Index Affect Outcomes in Robotic-Assisted Coronary Artery Bypass Procedures?

摘要

OBJECTIVE: Obese patients pose unique technical challenges for minimal-access cardiac surgery. We sought to examine the effect of body mass index on short-term outcomes in robotic-assisted coronary surgery. METHODS: From January 2010 to November 2011, a total of 110 consecutive patients underwent robotic-assisted coronary surgery at our institution. All patients had robotic-assisted mobilization of the left internal mammary artery. Some patients then underwent direct coronary anastomosis to the left anterior descending coronary artery via a left mini thoracotomy, whereas others had a complete robotic endoscopic procedure within the closed chest. The short-term outcomes of obese patients (n = 39), defined as body mass index greater than 30 kg/m, were compared with those of nonobese patients (n = 71). RESULTS: Mean left internal mammary artery harvest time was longer in obese patients than in nonobese patients (51.03 vs 39.94 minutes; P = 0.007), as was overall operative time (218.15 vs 186.72 minutes; P = 0.034). There were no significant differences in mortality or major morbidity between obese and nonobese patients. CONCLUSIONS: Obesity does not adversely affect short-term outcomes in robotic-assisted coronary surgery, although operative times are somewhat longer for these patients. Robotic-assisted coronary techniques can be safely pursued in obese patients.