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. 2022 Nov;37(11):3525-3535.
doi: 10.1111/jocs.16878. Epub 2022 Aug 23.

Robotic-assisted versus conventional off-pump coronary surgery in women: A propensity-matched study

Gianluca Torregrossa  1   2 , Michel Pompeu Sá  1   2 , Jef Van den Eynde  3 , John H Malin  4 , Aleksander Dokollari  2 , Ozgun Erten  2 , Tian Sun  1   2 , Serge Sicouri  2 , MaryAnn C Wertan  1 , Basel Ramlawi  1   2 , Francis P Sutter  1
Affiliations

Robotic-assisted versus conventional off-pump coronary surgery in women: A propensity-matched study

Gianluca Torregrossa et al. J Card Surg. 2022 Nov.

Abstract

Background: Off-pump coronary artery bypass (OPCAB) previously demonstrated its potential benefits in women; however, robotic-assisted OPCAB was scarcely studied.

Objectives: To investigate whether robotic-assisted OPCAB could further improve the outcomes in women and the potential impact of hybrid approaches with stents and completeness of revascularization on the late outcomes.

Methods: Women who underwent robotic-assisted or conventional OPCAB (with sternotomy) between May 2005 and January 2021 at Lankenau Heart Institute were included. Propensity score matching was used to match 273 pairs on 27 characteristics.

Results: In the intraoperative period, women who underwent robotic-assisted OPCAB presented longer operative times (6.00 vs. 5.38 h; p < 0.001), higher rates of extubation in the operating room (83.9% vs. 75.5%; p = 0.019) and lower rates of blood transfusion (13.2% vs. 32.2%; p < 0.001). In the postoperative period, women who underwent robotic-assisted OPCAB presented lower rates of new onset atrial fibrillation (16.8% vs. 25.6%; p = 0.016), need of blood transfusion (33.0% vs. 54.9%; p < 0.001), shorter intensive care unit (ICU) (46.1 vs. 49.8 h; p = 0.006) and hospital length of stay (5.0 vs. 6.0 days; p < 0.001). We observed no statistically significant differences in the rates of operative death between the groups (1.47% vs. 1.47%; p = 0.771). In the follow-up, we observed no differences in terms of overall survival regardless of hybrid procedures with stents and completeness of revascularization.

Conclusions: Robotic-assisted OPCAB in women is as safe as conventional OPCAB and may further improve outcomes. Hybrid coronary revascularization was a valuable adjunct in the robotic scenario and completeness of revascularization did not play a role in this setting.

Keywords: cardiac surgical procedures; cardiovascular surgical procedures; coronary artery bypass; female; off-pump; robotic surgical procedures.

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References

REFERENCES

    1. Gaudino M, Di Franco A, Alexander JH, et al. Sex differences in outcomes after coronary artery bypass grafting: a pooled analysis of individual patient data. Eur Heart J. 2021;43(1):18-28.
    1. ElBardissi AW, Aranki SF, Sheng S, O'Brien SM, Greenberg CC, Gammie JS. Trends in isolated coronary artery bypass grafting: an analysis of the Society of Thoracic Surgeons adult cardiac surgery database. J Thorac Cardiovasc Surg. 2012;143:273-281.
    1. Feldman S, Ammar W, Lo K, Trepman E, van Zuylen M, Etzioni O. Quantifying sex bias in clinical studies at scale with automated data extraction. JAMA Netw Open. 2019;2:e196700.
    1. Alam M, Lee VV, Elayda MA, et al. Association of gender with morbidity and mortality after isolated coronary artery bypass grafting. A propensity score matched analysis. Int J Cardiol. 2013;167:180-184.
    1. Kasirajan V, Wolfe LG, Medina A. Adverse influence of female gender on outcomes after coronary bypass surgery: a propensity matched analysis. Interact Cardiovasc Thorac Surg. 2009;8:408-411.

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