Mid Term Angiographic And Long Term Clinical Follow-up After Robotic Beating Heart Connector Tecab
Husam H. Balkhy, Sarah Nisivaco, Hiroto Kitahara, Mackenzie McCrorey, Brook Patel.
The University of Chicago Medical Center, Chicago, IL, USA.
BACKGROUND Robotic totally endoscopic coronary bypass on the beating heart can be facilitated using distal anastomotic coronary connectors. We have been performing this procedure using the C-port Flex A connector since 2007 and at our current institution since 2013. The purpose of this study was to analyze graft patency in all of our robotic connector TECAB patients who underwent patency evaluation via angiography at our current institution. METHODS Between 7/2013 to 11/2017 322 consecutive patients underwent robotic beating heart TECAB. 104 of these patients had a follow up angiogram which assessed graft patency. 73 were for planned hybrid procedures and 31 underwent an unplanned angiogram for a clinical indication. Retrospective analysis of the angiographic patency and clinical outcomes of these patients was performed. RESULTS 36 (35%) patients had a single-vessel bypass and 68 (65%) had multi-vessel grafting. The number of grafts evaluated was 174 (109 LIMA grafts and 65 RIMA grafts). Average length of time between surgery and angiographic follow up was 4.9 + 8.0 months. Overall graft patency was 95.4% (LIMA = 96%; RIMA = 94%). Mortality was 1/104 (0.96%). Average flow and PI in the grafts was 74.7 + 39.1 and 1.42 + 0.52, respectively. Long-term follow-up was available for 91 (88%) patients at a mean of 16.7 + 12.3 months. Mortality was 4.8%. 1 patient had re-intervention in culprit vessel. CONCLUSIONS In this series of 104 patients undergoing angiographic evaluation after robotic connector TECAB we found excellent mid term graft patency and longer term clinical outcomes in our hands
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