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?