Early Experience of Robotic-Assisted Coronary Artery Bypass Grafting

摘要

Purpose: Robotics facilitates minimally invasive cardiac surgery, and has been used to perform portions of coronary artery anastomoses via minimal thoracotomy incisions. This report shares our early experience of robotic-assisted coronary artery bypass grafting. Methods: The robotic-assisted endoscopic coronary artery bypass grafting of the left internal thoracic artery to the left anterior descending artery was performed by using the da Vinci robotic system. Two robotic instruments and one endoscopic camera were placed through three small ports. A robotic system was used to harvest the left internal thoracic artery; anastomoses were performed directly through a left anterior minimal thoracotomy under off-pump coronary artery bypass. Results: Between January 2005 and September 2005, the new instrumentation was used in 10 patients. The mean age of the patients was 59 years, and mean left ventricular ejection fraction was 62%. Two of the 10 patients received double coronary artery bypass grafts. They had a radial artery graft bridging the left internal thoracic artery to the diagonal branch through a small left anterior thoracotomy. No major complications were encountered in the postoperative period, except for one patient who was admitted because of left-side pleural effusion. The median length of stay in the intensive care unit was 2.2 days. The mdian postoperative hospital stay was 7.1 days. Conclusion: The results from this prospective clinical trial in our hospital showed favorable short-term outcome with no adverse events. Robotic assistance enables us to perform totally off-pump endoscopic coronary artery bypass.