Back to 2026 Abstracts
Percutaneous Bypass In Robotic Cardiac Surgery: A Single-center Experience
James Y. Lao1, Berk Inan2, Ian Mason3, Marco Tagliafierro3, Gerardo Ramos-Lemos3, Michael R. LaLonde3, Luigi Pirelli3, Isaac George3, Arnar Geirsson3.
1Hospital of the University of Pennsyvlania, Philadelphia, PA, USA, 2Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA, 3Division of Cardiothoracic Surgery, New York, NY, USA.
BACKGROUND: Total percutaneous bypass is the least invasive method of establishing extracorporeal circulation for cardiac surgery.
In this study, we evaluate the safety and short-term outcomes of total percutaneous bypass in robotic cardiac surgery from a single institution.
METHODS: Robotic cardiac surgery was performed on 217 consecutive patients using total percutaneous cannulation at a single institution between 2023 and 2025. Patients who underwent surgery using open surgical cannulation or hybrid (open and percutaneous) cannulation were excluded. Median length of follow-up was 51 days. Primary outcome was cannulation-related complications and secondary outcomes included reoperation, postoperative complications, and readmission for cannulation-related complications.
RESULTS: Cannulation access was achieved most commonly via the left femoral artery (84.3%, 183/217) and the right femoral vein (94.9%, 206/217). Two Perclose Proglide devices were placed in the arterial access site and one in the venous access site in all operations. The most common arterial cannula sizes were 21 Fr (63.6%, 136/217) and 23 Fr (29%, 62/217), while venous cannula size was predominantly 25 Fr (96.7%, 208/217). Single-valve procedures comprised 72.9% (158/217) of operations and double-valve procedures comprised 14.3% (31/217). Additional procedures included ASD/VSD closure (8.3%, 18/217), myxoma resection (2.8%, 6/217), and concomitant Cryo-Maze for atrial fibrillation (23.5%, 51/217). Endo-aortic balloon occlusion was used in 97.2% (211/217). Postoperative CVA occurred in three (1.4%) patients. Reoperation for femoral artery pseudoaneurysm occurred in two (0.9%) patients and reoperation for bleeding in seven (3.2%) patients. Postoperative atrial fibrillation occurred in 14.7% (32/217) of patients, and 0.9% (2/217) of patients required a permanent pacemaker. Median hospital length of stay was four days. Readmission within 30 days occurred in 26 (12%) patients, including four (1.8%) for cannulation-related complications. No infections were observed. Groin complications occurred in six (2.8%) patients, deep vein thrombosis in one (0.5%) patient, and overall cannulation-related complications in seven (3.2%) patients.
CONCLUSIONS: Robotic cardiac surgery using total percutaneous cannulation was associated with excellent early outcomes, no infections or mortality, and a low incidence of groin and vascular complications, supporting the safety and feasibility of this minimally invasive technique.
LEGEND: Institutional Experience with Percutaneous Bypass for Robotic Cardiac Surgery
Back to 2026 Abstracts
