ROBOTIC AND HYBRID CORONARY REVASCULARIZATION READY...
Transcript of ROBOTIC AND HYBRID CORONARY REVASCULARIZATION READY...
ROBOTIC AND HYBRID CORONARY REVASCULARIZATION
READY FOR PRIME TIME?
J. Bonatti + Robotic CABG Team
Cardiac Surgery
University of Maryland School of Medicine and Medical Center
THE TOOLBOX IS GROWING
Double IMA
Sequential grafting
Y-Grafts LIMA/RIMA/ Radial artery
Aortocoronary vein grafts Aortocoronary vein grafts
Axillocoronary vein grafts
Beating heart
Arrested heart (Endoballoon, Chitwood clamp)
AXCOR
AXCOR
LAD
LIMARIMA
Y
WORLD’S FIRST TOTALLY ENDOSCOPIC QUADRUPLE BYPASS – ARRESTED HEART
Dg
Advanced Hybrid Coronary Intervention
Advanced Hybrid Coronary Intervention
PERIOPERATIVE RESULTS MEET CABG STANDARDS
TECAB 6/2001 - 4/2012 (n=601)
TECAB x 1 368 (61.2%)
TECAB x 2 199 (33.1%)
TECAB x 3 31 (5.2%)
TECAB x 4 3 (0.5%)
Endo-Cardioplegia 468 (77.4%)
Beating Heart 133 (22.1%)
Anastomoses 871
TECAB 6/2001 - 4/2012 (n=601)
Ventilation time (h) 9 (0-704)
ICU stay (h) 23 (11-1048)ICU stay (h) 23 (11-1048)
Hospital stay (d) 6 (2-54)
Mortality 7 (1.2%)
Cumulative Freedom from Graft reintervention (PCI or CABG)
96.5% (5 Years)
Graft failure rate
3.5% (5 years)
TECAB 2001 – 2012 n = 601
ARTS 92%
BOYLAN 1994 97%
LIMA LAD CCF
TECAB 2001 – 2012 n = 601
ARTS 78%
GREENBAUM LIMA LAD
CONV CABG 79%
SYNTAX CABG 80%
MOST SIGNIFICANT BENEFIT IN THE
EARLY REHABILITATION PHASEEARLY REHABILITATION PHASE
Quality of life after AH-TECAB - Hybrid
3 weeks postop
THE FUTURE?THE FUTURE?