Hybrid and Robotic-Assisted Coronary Artery Revascularization Compared to Conventional Coronary Artery Bypass Graft Revascularization

Objectives: Data were evaluated to compare hybrid and robotic revascularization procedures with conventional coronary artery bypass grafting for the treatment of multi vessel coronary artery disease. Background: Hybrid coronary revascularization provides an alternative approach to conventional coronary artery bypass graft and percutaneous intervention revascularization therapies. Data comparing the two strategies are limited. Methods: A retrospective evaluation was conducted on patients who underwent coronary revascularization by hybrid, robotic alone or conventional coronary artery bypass grafting from 2003 through 2014 at the University of Minnesota medical center by a single operator. Results: A total of 399 patients were included in the comparison with 31 hybrid, 68 robotic-only and 300 conventional coronary bypass patients. Mean OR times and hospital stay durations were decreased for hybrid and robotic-only procedures in comparison to conventional bypass procedures. Peri-operative blood product requirements were also decreased in the hybrid group and robotic-only groups. Postoperative stroke events occurred in 3 patients (1%) in the conventional bypass group, but did not occur in the hybrid or robotic-only groups. Similarly, post-operative death occurred in 5 patients (1.7%) in the conventional bypass group, but did not occur in the hybrid or robotic-only groups. Conclusion: Hybrid and robotic-assisted coronary revascularization are both effective therapies for multi vessel coronary artery disease. The hybrid and robotic-assisted strategies allow for minimal invasion, which translates into shorter operative and hospital length of stay durations, decreased blood product requirements and seemingly fewer stroke and death events.