Robotic hand-sewn anastomosis versus anastomotic connector in beating-heart totally endoscopic coronary artery bypass: A propensity-matched studyCentral MessagePerspective
Objective: To compare the outcomes of a robotic hand-sewn anastomosis versus a distal coronary anastomotic connector in single-vessel robotic beating-heart totally endoscopic coronary artery bypass (TECAB). Methods: Of a total 811 patients undergoing robotic TECAB between July 2013 and September 202...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-03-01
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| Series: | JTCVS Structural and Endovascular |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2950605025000014 |
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| author | Hiroto Kitahara, MD Sarah Nisivaco, MD Brooke Patel, MSN Sandeep Nathan, MD Husam H. Balkhy, MD |
| author_facet | Hiroto Kitahara, MD Sarah Nisivaco, MD Brooke Patel, MSN Sandeep Nathan, MD Husam H. Balkhy, MD |
| author_sort | Hiroto Kitahara, MD |
| collection | DOAJ |
| description | Objective: To compare the outcomes of a robotic hand-sewn anastomosis versus a distal coronary anastomotic connector in single-vessel robotic beating-heart totally endoscopic coronary artery bypass (TECAB). Methods: Of a total 811 patients undergoing robotic TECAB between July 2013 and September 2023, 301 consecutive patients (37%) who underwent left internal thoracic artery to the left anterior descending artery bypass were included in this study. The anastomotic connector was used in 129 patients and robotic hand-sewn in 172 patients. Propensity matching identified 100 matched pairs of anastomotic connector (group 1) and hand-sewn (group 2) for analysis. The intraoperative and postoperative data were compared. Results: After propensity matching, there were no significant differences in baseline characteristics. The median operative time was shorter in group 1 (140 minutes vs 172 minutes, P = .001). Left internal thoracic artery-left anterior descending flow was similar (group 1: 85 mL/min vs group 2: 95 mL/min, P = .164). The length of hospital stay was shorter in the group 2 (2.5 ± 0.9 days, vs 2.0 ± 0.7 days, P = .001). In-hospital mortality was similar between the groups (group 1: 1.0%, vs group 2: 0%, P = 1.000). Freedom from major adverse cardiovascular events at 1 year was 91.8% in group 1 and 96.9% in group 2 (P = .072). Conclusions: The use of an anastomotic connector in single-vessel robotic TECAB was associated with shorter operative time. Both anastomotic techniques demonstrated excellent 1-year outcomes. |
| format | Article |
| id | doaj-art-5b8eeb224b7a4c8c8aade9f4b1e21b07 |
| institution | DOAJ |
| issn | 2950-6050 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTCVS Structural and Endovascular |
| spelling | doaj-art-5b8eeb224b7a4c8c8aade9f4b1e21b072025-08-20T03:05:49ZengElsevierJTCVS Structural and Endovascular2950-60502025-03-01510004210.1016/j.xjse.2025.100042Robotic hand-sewn anastomosis versus anastomotic connector in beating-heart totally endoscopic coronary artery bypass: A propensity-matched studyCentral MessagePerspectiveHiroto Kitahara, MD0Sarah Nisivaco, MD1Brooke Patel, MSN2Sandeep Nathan, MD3Husam H. Balkhy, MD4Department of Surgery, Section of Cardiac Surgery, The University of Chicago Medicine, Chicago, IllDepartment of Surgery, Section of Cardiac Surgery, The University of Chicago Medicine, Chicago, IllDepartment of Surgery, Section of Cardiac Surgery, The University of Chicago Medicine, Chicago, IllDepartment of Medicine, Section of Cardiology, The University of Chicago Medicine, Chicago, IllDepartment of Surgery, Section of Cardiac Surgery, The University of Chicago Medicine, Chicago, Ill; Address for reprints: Husam H. Balkhy, MD, Department of Surgery, Section of Cardiac Surgery, The University of Chicago, 5841 S. Maryland Ave, MC5040, Chicago, IL 60637.Objective: To compare the outcomes of a robotic hand-sewn anastomosis versus a distal coronary anastomotic connector in single-vessel robotic beating-heart totally endoscopic coronary artery bypass (TECAB). Methods: Of a total 811 patients undergoing robotic TECAB between July 2013 and September 2023, 301 consecutive patients (37%) who underwent left internal thoracic artery to the left anterior descending artery bypass were included in this study. The anastomotic connector was used in 129 patients and robotic hand-sewn in 172 patients. Propensity matching identified 100 matched pairs of anastomotic connector (group 1) and hand-sewn (group 2) for analysis. The intraoperative and postoperative data were compared. Results: After propensity matching, there were no significant differences in baseline characteristics. The median operative time was shorter in group 1 (140 minutes vs 172 minutes, P = .001). Left internal thoracic artery-left anterior descending flow was similar (group 1: 85 mL/min vs group 2: 95 mL/min, P = .164). The length of hospital stay was shorter in the group 2 (2.5 ± 0.9 days, vs 2.0 ± 0.7 days, P = .001). In-hospital mortality was similar between the groups (group 1: 1.0%, vs group 2: 0%, P = 1.000). Freedom from major adverse cardiovascular events at 1 year was 91.8% in group 1 and 96.9% in group 2 (P = .072). Conclusions: The use of an anastomotic connector in single-vessel robotic TECAB was associated with shorter operative time. Both anastomotic techniques demonstrated excellent 1-year outcomes.http://www.sciencedirect.com/science/article/pii/S2950605025000014totally endoscopic coronary artery bypassanastomotic connector |
| spellingShingle | Hiroto Kitahara, MD Sarah Nisivaco, MD Brooke Patel, MSN Sandeep Nathan, MD Husam H. Balkhy, MD Robotic hand-sewn anastomosis versus anastomotic connector in beating-heart totally endoscopic coronary artery bypass: A propensity-matched studyCentral MessagePerspective JTCVS Structural and Endovascular totally endoscopic coronary artery bypass anastomotic connector |
| title | Robotic hand-sewn anastomosis versus anastomotic connector in beating-heart totally endoscopic coronary artery bypass: A propensity-matched studyCentral MessagePerspective |
| title_full | Robotic hand-sewn anastomosis versus anastomotic connector in beating-heart totally endoscopic coronary artery bypass: A propensity-matched studyCentral MessagePerspective |
| title_fullStr | Robotic hand-sewn anastomosis versus anastomotic connector in beating-heart totally endoscopic coronary artery bypass: A propensity-matched studyCentral MessagePerspective |
| title_full_unstemmed | Robotic hand-sewn anastomosis versus anastomotic connector in beating-heart totally endoscopic coronary artery bypass: A propensity-matched studyCentral MessagePerspective |
| title_short | Robotic hand-sewn anastomosis versus anastomotic connector in beating-heart totally endoscopic coronary artery bypass: A propensity-matched studyCentral MessagePerspective |
| title_sort | robotic hand sewn anastomosis versus anastomotic connector in beating heart totally endoscopic coronary artery bypass a propensity matched studycentral messageperspective |
| topic | totally endoscopic coronary artery bypass anastomotic connector |
| url | http://www.sciencedirect.com/science/article/pii/S2950605025000014 |
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