Back to 2025 Cardiac Abstracts
Does Robotic Totally Endoscopic Coronary Bypass Eliminate Gender Bias In Bilateral Internal Thoracic Artery Grafting?
Sarah Nisivaco1, Hiroto Kitahara
1, Riya Bhasin
1, Niv Ad
2, Husam H. Balkhy
1.
1University of Chicago Medicine, Chicago, IL, USA,
2Johns Hopkins University, Baltimore, MD, USA.
BACKGROUND: Use of bilateral internal thoracic artery grafting (BITA) in women undergoing coronary bypass surgery is notoriously low. Reports in the literature cite concern for sternal wound infection (SWI), despite demonstrated benefits including superior long-term survival. We reviewed our female patients undergoing robotic totally-endoscopic coronary bypass (TECAB) with BITA grafting.
METHODS: Single-center, retrospective study of 937 patients undergoing robotic beating-heart TECAB between 7/2013-12/2024. Female patients who received BITA grafting were analyzed. Early and midterm clinical outcomes and early angiographic graft patency were reviewed.
RESULTS: Of 937 total TECAB patients over 11 years, 213 (23%) were female. Of these, 85 patients (40%) underwent multivessel grafting, of which 82% received BITA. Of 720 male patients, 416 (45%) underwent multivessel grafting, of which 87% received BITA. Between the 2 genders, BITA use was not significantly different (p=0.229).Mean age was 67.5±8 years; 46% had diabetes, (24% insulin-dependent). Average BMI was 29.5±6.3; mean STS score was 2.5+3.4%. 6 patients (9%) underwent 3-vessel TECAB, the remainder underwent 2-vessel grafting. There were no conversions to sternotomy. Mean hospital stay was 2.6±0.8 days. 13% had postoperative AF. There were no take-backs for bleeding, strokes, or wound infections. There was 1 hospital mortality due to malignant arrhythmia in a patient with patent grafts. Follow-up was 100% complete at 48±39 months. There were 15 deaths (21%), 4 cardiac-related (5.7%). 2 patients had redo cardiac surgery (AVR 2-years postop and LVAD 1-year postop). There were 3 MIs (4%), none in a surgical culprit vessel; 5 patients had unplanned postop PCI (7%), 2 in a surgical culprit vessel (2.9%). In 34 patients (49%) who had hybrid revascularization, graft patency was 94% (32/34 grafts) at 2.6-months mean postoperatively.
CONCLUSIONS: BITA grafting in female patients undergoing multivessel robotic TECAB was used at a frequency similar to male patients.This approach was safe with good early and midterm outcomes (including in women with traditional risk factors), and can potentially extend the benefits of BITA grafting to more female patients with zero risk for SWI.
Back to 2025 Cardiac Abstracts
