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Establishment And Three Years Outome Of Robotic-assisted Hybrid Coronary Revascularization In The Middle East
Salman W. Bafageeh1, Uthman Aluthman1, Mohammed Ashour2, Hani I. Barnawi1, Abdulbadee A. Bogis1, Rawan Alamri1, Ahmed Elmahrouk1, Mohammad Shihata1, Ahmed Jamjoom1.
1King Faisal Specialist hospital and research center, Jeddah, Saudi Arabia, 2King Abdulaziz university, Jeddah, Saudi Arabia.

BACKGROUND:Hybrid coronary revascularization (HCR) is an evolving technique that merges the best of surgery and PCI approach for the treatment of multivessel. The surgical component of the procedure is minimally invasive and can be done using robotic technology which avoids the need of sternotomy. Our objective is to study 3 years outcomes of all patients who underwent robotic assisted HCR in King Faisal Specialist Hospital and Research Center in Jeddah to evaluate the feasibility and safeness of the procedure to establish the robotic program in KSA.
METHODS: This study is a retrospective chart review conducted at king Faisal Specialist Hospital and Research Center in Jeddah, focusing on patients who underwent robotic assisted HCR from 2018-2021. Patientsí data was extracted from the hospital electronic system and move to excel sheet. The study was approved by the institutional review board of king Faisal Specialist Hospital and Research Center #2020-103.
RESULTS: The study included 78 patients (mean age, 56 years [range, 43 to 72 years]; 98% males) underwent robotic assisted HCR on an intention of basis. (28 patients had PCI to the right coronary artery, 17 patients had PCI to the Circumflex artery and 22 patients had PCI for both. there was no hospital mortality, average hospital LOS was 9 days and 92.2% of the patients had no blood transfusion. There was no postoperative major cardiac and cerebral events and postoperative complications was 6.4%. only one patient was converted to sternotomy and re-exploration for bleeding was 6.4%. The average operation time was recorded as 3.8 hours with an ICU LOS less than 24 hours.
CONCLUSIONS: Robotic-assisted HCR enables surgical treatment of multivessels coronary artery disease with minimal trauma, shorter hospital LOS and ICU, shorter recovery time, and minimal or no need for blood transfusion. Eventually, the effectiveness and safety of the process has been proven by the perfect postoperative complications were recorded.

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