Clinical Outcomes Of Cor-knot Micro Application In Robotic-assisted Coronary Artery Bypass Grafting
Aleksander Dokollari1, Serge Sicouri2, Ozgun Erten2, Basel Ramlawi1, Francis Sutter1, Gianluca Torregrossa1.
1Lankenau Medical Center, Wynnewood, PA, USA, 2Lankenau Institute for Medical Research, Wynnewood, PA, USA.
BACKGROUND: Robotic-assisted cardiac surgery is a subspecialty of coronary artery bypass grafting (CABG) and COR-KNOT Micro is a special type of knot utilized in robotic-assisted CABG procedures for LITA-LAD anastomosis. • However, angiographic and clinical outcomes of this procedure have yet to be determined. • The objective of this study is to report follow-up angiographic findings and clinical outcomes following robotic-assisted CABG intervention using COR-KNOT Micro. METHODS: • This is an observational cohort study of consecutive patients undergoing CABG at our institute between June 2021- August 2022. Patients were included by all demographics and preoperative characteristics. • Procedure characteristics included COR-KNOT Micro use. • Inclusion criteria; patients undergoing robotic-assisted revascularization with COR-KNOT Micro. • Primary outcome was analysis of angiographic findings in COR-KNOT Micro patients after robotic-assisted CABG. • Secondary outcomes at follow-up included, overall death, cardiac death, cardiac readmission, stroke, myocardial infarction (MI), repeat revascularization, angina, and MACCE. RESULTS: • 28 patients received COR-KNOT Micro at LITA-LAD anastomosis. • Patients mean age was 70.07 ± 10.8 years, the STS score was 1.5 ± 1.3, 32% had diabetes, 25% had previous cerebrovascular events, 28% had previous percutaneous coronary intervention and 64% had previous MI. • All patients had LITA graft anastomosis to LAD and 75% of them were extubated in the operating room. Mean postoperative ventilation time was 1.6 ± 8.3 hours. • All new patients had off-pump surgery and there was no conversion to full sternotomy. • There was no in-hospital death. • Angiographic findings at follow-up found no stenosis of the anastomosis and stents. - One patient died at 30-days follow-up due to iatrogenic liver injury. CONCLUSIONS:• COR-KNOT Micro in LITA to LAD anastomosis for robotic-assisted CABG provides good angiographic findings and clinical outcomes in selected patients. Heart-team collaboration with the cardiologist as well as a dedicated team of experienced off-pump anesthesia and perfusionist and intensivists is also crucial in achieving excellent results. 
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