Mid-term results and patient perceptions of robotically-assisted coronary artery bypass grafting.

Overview

We sought to study our mid-term outcomes and our patient's perceptions of robotically-assisted coronary artery bypass (RACAB). The daVinci robotic system was utilized to harvest and prepare the internal thoracic artery (ITA) as well as to open the pericardium and identify the target vessels. Anastomoses were performed by hand on the beating heart through limited incisions using an endoscopic stabilizing device. A follow-up telephone interview was conducted with patients at 3 to 6 months. Between 4/12/02 and 11/1/04, 37 patients underwent RACAB (1.2 distal anastomoses/patient). Median length of stay was 3 days (2-14 days) and 82% of patients reported full return to baseline activity within 10 days of surgery. There were two early LITA complications and one late anastomotic stenosis all of which occurred within the first two cases of each surgeon's experience. The majority of patients surveyed (95%) knew that robotics were involved in their surgery and most patients (95%) would recommend RACAB (95%). RACAB is an effective minimally invasive revascularization technique with excellent recovery times and high patient satisfaction. The early complication rate emphasizes the steep learning curve for this procedure as well as the need for intensive pre-procedure training.