Robotic-assisted versus conventional off-pump coronary surgery in women: A propensity-matched study

Gianluca Torregrossa, Sá Michel Pompeu, Jef Van den Eynde, John H. Malin, Aleksander Dokollari, Ozgun Erten, Tian Sun, Serge Sicouri, Mary Ann C. Wertan, Basel Ramlawi, Francis P. Sutter

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background: Off-pump coronary artery bypass (OPCAB) previously demonstrated its potential benefits in women; however, robotic-assisted OPCAB was scarcely studied. Objectives: To investigate whether robotic-assisted OPCAB could further improve the outcomes in women and the potential impact of hybrid approaches with stents and completeness of revascularization on the late outcomes. Methods: Women who underwent robotic-assisted or conventional OPCAB (with sternotomy) between May 2005 and January 2021 at Lankenau Heart Institute were included. Propensity score matching was used to match 273 pairs on 27 characteristics. Results: In the intraoperative period, women who underwent robotic-assisted OPCAB presented longer operative times (6.00 vs. 5.38 h; p < 0.001), higher rates of extubation in the operating room (83.9% vs. 75.5%; p = 0.019) and lower rates of blood transfusion (13.2% vs. 32.2%; p < 0.001). In the postoperative period, women who underwent robotic-assisted OPCAB presented lower rates of new onset atrial fibrillation (16.8% vs. 25.6%; p = 0.016), need of blood transfusion (33.0% vs. 54.9%; p < 0.001), shorter intensive care unit (ICU) (46.1 vs. 49.8 h; p = 0.006) and hospital length of stay (5.0 vs. 6.0 days; p < 0.001). We observed no statistically significant differences in the rates of operative death between the groups (1.47% vs. 1.47%; p = 0.771). In the follow-up, we observed no differences in terms of overall survival regardless of hybrid procedures with stents and completeness of revascularization. Conclusions: Robotic-assisted OPCAB in women is as safe as conventional OPCAB and may further improve outcomes. Hybrid coronary revascularization was a valuable adjunct in the robotic scenario and completeness of revascularization did not play a role in this setting.

Original languageEnglish
Pages (from-to)3525-3535
Number of pages11
JournalJournal of Cardiac Surgery
Volume37
Issue number11
DOIs
StatePublished - Nov 2022
Externally publishedYes

Keywords

  • cardiac surgical procedures
  • cardiovascular surgical procedures
  • coronary artery bypass
  • female
  • off-pump
  • robotic surgical procedures

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