Exhibitors & Sponsors
Past Meetings
Future Meetings

Back to 2015 Cardiac Track Program Overview

Wireless Technology Demonstrates that Physical Capabilities in the Early Phase of Recovery are Enhanced by Less Invasive, Robotic CABG
Robert S. Poston, Jr..
Northwest medical center, Tucson, AZ, USA.

OBJECTIVE: Prolonged recovery time is a major shortcoming of standard CABG (st-CABG) that drives the search for non-sternotomy alternatives. Subjective reports about less invasive CABG using robotics (r-CABG) suggest an improved recovery time. However, an objective, head-to-head comparison against st-CABG is lacking. We compared patients that underwent either st-CABG vs. r-CABG using a series of objective measures of recovery time.
METHODS: Inclusion criteria for this prospective study of postoperative recovery included all patients with an STS risk score < 2% undergoing CABG via sternotomy vs. robotic techniques at a single center. Daily distance walked was monitored for the first two weeks after surgery as an inpatient and outpatient using a wireless tracking device (Fitbit™, San Francisco, CA). Before and at 3 weeks after CABG, each subject was tested for exercise tolerance at maximal (treadmill maximum 02 consumption, MVO2) and submaximal effort (distance in the 6-minute walk test) and surveyed by the Duke Activity Status Index (DASI). Postop results were normalized against baseline values.
RESULTS: A total of 40 CABG patients (20 patients in each group) were recruited over a 2 year enrollment period. While both groups showed steady daily improvement in their walking distances, the r-CABG group walked 3-fold longer during the 2 week evaluation period (0.5±1.0 vs. 1.7±1.5 miles/day, p=0.02). At 3 weeks after surgery, the st-CABG group showed 43±38% recovery in MVO2, 56±31% recovery in 6 min walk test and 47±29% in DASI scores. The r-CABG group showed a statistically significant improvement in DASI score vs. st-CABG (97±56% recovery, p=0.04, heteroscedastic t-test). Most r-CABG patients showed a full recovery at 3 weeks in MVO2 (93±23%), 6 min walk distance (96±28%), but this was not statistically significant because of more variability in performance between patients.
CONCLUSIONS: In low risk patients, our study showed that smaller surgical incisions were associated with a quicker recovery of submaximal effort (e.g. daily walking distance, DASI score). Such an advantage documents the societal benefit of r-CABG because it usually translates into quicker return to work and less absenteeism, providing a strong financial rationale for this procedure.

Back to 2015 Cardiac Track Program Overview
© 2020 International Society for Minimally Invasive Cardiothoracic Surgery. All Rights Reserved. Read Privacy Policy.