Long-term Outcomes Of Robotic Hybrid Coronary Artery Revascularization. A Single Center Experience.
Aleksander Dokollari, Serge Sicouri, Michel Pompeu Sa, Basel Ramlawi, Leila Hosseinian, Francis Sutter, Gianluca Torregrossa.
Lankenau Medical Center, Wynnewood, PA, USA.
BACKGROUND: The impact of long-term complications after CABG, including repeat revascularization, myocardial infarction (MI), and persistent angina in patients undergoing robotic hybrid coronary revascularization (HCR) remain limited. In the present study, we sought to determine risk factors for coronary events after robotic HCR and their time-varying effects on outcomes. METHODS: We identified all patients who underwent robotic HCR between May 2005 and June 2021 at our institute. Baseline characteristics were explored as possible risk factors for angina, MI and non-planned repeat revascularization with stents at any time during the follow-up after the index procedures. RESULTS: A total of 875 consecutive patients (mean age 71.1±11.1 years) underwent robotic HCR at our institution. After a median follow-up of 3.32 years (IQR 1.18-6.34 years), angina occurred in 134 patients (15.3%), repeat revascularization with stents in 137 patients (15.7%), and MI in 36 patients (4.1%). The hazard rates for all outcomes increased with follow-up time, with a notable early rise around 2 years of follow-up for angina and, to a lesser extent, repeat revascularization. We identified risk factors for events with constant and time-varying effects, including female sex, Black race, obesity and use of saphenous vein grafts and radial artery graft.
CONCLUSIONS: After robotic HCR, the identification of risk factors on the time horizon (both constant and time-varying hazards) is important for guiding appropriate surveillance at follow-up. 
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