IMMEDIATE CLINICAL OUTCOME OF ROBOTIC ASSISTED CABG IN PATIENTS WITH PREVIOUS HEART SURGERY

Abstract

Redo Coronary artery bypass graft surgery on cardiopulmonary bypass is associated with significant morbidity and mortality in patients with previous heart surgery. In high risk patients like this, minimally invasive robotic-assisted surgical techniques can reduce adverse events, having a faster recovery and return to their normal activities. We evaluate the postoperative evolution of three patients with previous heart surgery that were treated with robotic-assisted coronary artery bypass grafting. We perform single coronary artery bypass graft surgery off pump in three male patients, between 2008 and 2013, using the DaVinci Si System. The three of them had previous aortocoronary bypass surgery without the utilization of Leith internal thoracic artery (LITA). Average age was 72.99 + 5.99 years old. The three procedures were urgent, and the patients were one in CCS Class 4a, other in CCS Class 4b and other in CCS Class 4c. All of them were diabetics, with no renal dysfunction. Surgery was performed using off pump technique, harvesting the LITA with the robot, and performing the anastomosis of IMA to LAD through a small left anterior minithoracotomy. No patient died or had any postoperative complication. The average ICU stay was of 1.3 + 0.58 days with a maximum ICU days of 2. The average hospital stay was of 3.3 + 0.58 days with a maximum hospital days of 4. The immediate postoperative results of robotic assisted single coronary artery bypass surgery in patients with previous heart surgery demonstrate great reproducible and efficacious results. This alternative approach enables possibility of reduce morbidity and mortality, with a faster recovery and return to their daily activities. Though our experience needs to evaluate more patients with this condition, the future results seem promising.