Experience in setting up non-robotic minimally invasive direct coronary artery bypass grafting in a non-routine off-pump coronary artery bypass center
Abstract Background The safety of minimally invasive direct coronary artery bypass (MIDCAB) has been proven. Nevertheless, reports on clinical outcomes in MIDCAB and the learning curve of this challenging technique in a non-routine off-pump coronary artery bypass (OPCAB) center are still limited. He...
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BMC
2025-01-01
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| Series: | European Journal of Medical Research |
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| Online Access: | https://doi.org/10.1186/s40001-025-02320-0 |
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| author | Yukiharu Sugimura Tomoyuki Suzuki Sebastian Johannes Bauer Friederike Irmgard Schoettler Moritz Benjamin Immohr Michael André Maliwa Arash Mehdiani Lachmandath Tewarie Gereon Schaelte Ajay Moza Payam Akhyari |
| author_facet | Yukiharu Sugimura Tomoyuki Suzuki Sebastian Johannes Bauer Friederike Irmgard Schoettler Moritz Benjamin Immohr Michael André Maliwa Arash Mehdiani Lachmandath Tewarie Gereon Schaelte Ajay Moza Payam Akhyari |
| author_sort | Yukiharu Sugimura |
| collection | DOAJ |
| description | Abstract Background The safety of minimally invasive direct coronary artery bypass (MIDCAB) has been proven. Nevertheless, reports on clinical outcomes in MIDCAB and the learning curve of this challenging technique in a non-routine off-pump coronary artery bypass (OPCAB) center are still limited. Here, we introduce our clinical outcomes of non-robotic MIDCAB. Methods Between August 2022 and March 2024, 72 consecutive patients with a mean age of 67.4 ± 9.5 years underwent non-robotic MIDCAB (defined as off-pump bypass grafting of the left internal mammary artery to the left anterior descending artery through left-sided mini-thoracotomy). We analyzed operation time and incidence of major adverse cardiac and cerebrovascular events (MACCE). Further, subgroup analyses included body mass index (BMI) with a cut-off of 30 kg/m2 [BMI ≧ 30: n = 18 (25.0%)] and body surface area (BSA) with a cut-off of 2.0 m2 [BSA ≧ 2.0: n = 34 (47.2%)]. Results All patients survived, whereas MACCE occurred in 4 patients (5.6%). By correlation analyses, no learning curve for operation time was observed in all cases analysis (p = 0.79), but MACCE (n = 4, 5.6%) exclusively observed in the first 34 patients. Furthermore, BMI ≧ 30 or BSA ≧ 2.0 was not significantly related to longer operation time (p = 0.42 and p = 0.52, respectively) and MACCE (p = 0.26 and p = 0.35, respectively). In addition, body size had no effect on operation time according to multiple regression analysis (p = 0.36). Conclusions Our study suggested that implementing non-robotic MIDCAB can be safely accomplished at a center with no previous routine in OPCAB surgery, even for patients with bigger body sizes. MACCE occurs more frequently in the early stages when adopting this surgical technique. |
| format | Article |
| id | doaj-art-22267a6fc3474cc5bbecff35fd247fd0 |
| institution | Kabale University |
| issn | 2047-783X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | European Journal of Medical Research |
| spelling | doaj-art-22267a6fc3474cc5bbecff35fd247fd02025-02-02T12:13:54ZengBMCEuropean Journal of Medical Research2047-783X2025-01-013011910.1186/s40001-025-02320-0Experience in setting up non-robotic minimally invasive direct coronary artery bypass grafting in a non-routine off-pump coronary artery bypass centerYukiharu Sugimura0Tomoyuki Suzuki1Sebastian Johannes Bauer2Friederike Irmgard Schoettler3Moritz Benjamin Immohr4Michael André Maliwa5Arash Mehdiani6Lachmandath Tewarie7Gereon Schaelte8Ajay Moza9Payam Akhyari10Department of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Center Essen, University Duisburg-EssenDepartment of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Center Essen, University Duisburg-EssenDepartment of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Center Essen, University Duisburg-EssenDepartment of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Center Essen, University Duisburg-EssenDepartment of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Center Essen, University Duisburg-EssenDepartment of Cardiac Surgery, Medical Faculty and RWTH University Hospital Aachen, RWTH Aachen UniversityDepartment of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Center Essen, University Duisburg-EssenDepartment of Cardiac Surgery, Medical Faculty and RWTH University Hospital Aachen, RWTH Aachen UniversityDepartment of Anesthesiology, Medical Faculty and RWTH University Hospital Aachen, RWTH Aachen UniversityDepartment of Cardiac Surgery, Medical Faculty and RWTH University Hospital Aachen, RWTH Aachen UniversityDepartment of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Center Essen, University Duisburg-EssenAbstract Background The safety of minimally invasive direct coronary artery bypass (MIDCAB) has been proven. Nevertheless, reports on clinical outcomes in MIDCAB and the learning curve of this challenging technique in a non-routine off-pump coronary artery bypass (OPCAB) center are still limited. Here, we introduce our clinical outcomes of non-robotic MIDCAB. Methods Between August 2022 and March 2024, 72 consecutive patients with a mean age of 67.4 ± 9.5 years underwent non-robotic MIDCAB (defined as off-pump bypass grafting of the left internal mammary artery to the left anterior descending artery through left-sided mini-thoracotomy). We analyzed operation time and incidence of major adverse cardiac and cerebrovascular events (MACCE). Further, subgroup analyses included body mass index (BMI) with a cut-off of 30 kg/m2 [BMI ≧ 30: n = 18 (25.0%)] and body surface area (BSA) with a cut-off of 2.0 m2 [BSA ≧ 2.0: n = 34 (47.2%)]. Results All patients survived, whereas MACCE occurred in 4 patients (5.6%). By correlation analyses, no learning curve for operation time was observed in all cases analysis (p = 0.79), but MACCE (n = 4, 5.6%) exclusively observed in the first 34 patients. Furthermore, BMI ≧ 30 or BSA ≧ 2.0 was not significantly related to longer operation time (p = 0.42 and p = 0.52, respectively) and MACCE (p = 0.26 and p = 0.35, respectively). In addition, body size had no effect on operation time according to multiple regression analysis (p = 0.36). Conclusions Our study suggested that implementing non-robotic MIDCAB can be safely accomplished at a center with no previous routine in OPCAB surgery, even for patients with bigger body sizes. MACCE occurs more frequently in the early stages when adopting this surgical technique.https://doi.org/10.1186/s40001-025-02320-0Minimally invasive direct coronary artery bypassMIDCABMICS-CABGHybrid |
| spellingShingle | Yukiharu Sugimura Tomoyuki Suzuki Sebastian Johannes Bauer Friederike Irmgard Schoettler Moritz Benjamin Immohr Michael André Maliwa Arash Mehdiani Lachmandath Tewarie Gereon Schaelte Ajay Moza Payam Akhyari Experience in setting up non-robotic minimally invasive direct coronary artery bypass grafting in a non-routine off-pump coronary artery bypass center European Journal of Medical Research Minimally invasive direct coronary artery bypass MIDCAB MICS-CABG Hybrid |
| title | Experience in setting up non-robotic minimally invasive direct coronary artery bypass grafting in a non-routine off-pump coronary artery bypass center |
| title_full | Experience in setting up non-robotic minimally invasive direct coronary artery bypass grafting in a non-routine off-pump coronary artery bypass center |
| title_fullStr | Experience in setting up non-robotic minimally invasive direct coronary artery bypass grafting in a non-routine off-pump coronary artery bypass center |
| title_full_unstemmed | Experience in setting up non-robotic minimally invasive direct coronary artery bypass grafting in a non-routine off-pump coronary artery bypass center |
| title_short | Experience in setting up non-robotic minimally invasive direct coronary artery bypass grafting in a non-routine off-pump coronary artery bypass center |
| title_sort | experience in setting up non robotic minimally invasive direct coronary artery bypass grafting in a non routine off pump coronary artery bypass center |
| topic | Minimally invasive direct coronary artery bypass MIDCAB MICS-CABG Hybrid |
| url | https://doi.org/10.1186/s40001-025-02320-0 |
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