Right-Sided Minimally Invasive Direct Coronary Artery Bypass: Clinical Experience and Perspectives
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Patients’ Characteristics
2.2. Patient Management and Preoperative Planning
2.3. Surgical Technique
2.4. Postoperative Management
2.5. Data Collection, Follow-Up and Outcome
2.6. Statistical Analysis
3. Results
3.1. Patients’ Demographics and Preoperative Data
3.2. Intra- and Early Postoperative Outcomes
3.3. Follow-Up
4. Discussion
Study Strengths and Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | CAD (n = 7) | ARCA (n = 4) | Total (n = 11) | |
---|---|---|---|---|
Number/%/Mean ± SD | Number/%/Mean ± SD | Number/%/Mean ± SD | ||
Age (years) | 60.1 (±18.2) | 66.3 (±8.9) | 62.4 (±15.3) | |
Female | 3 (42.9) | 2 (50.0) | 5 (45.5) | |
BMI | 27.8 (±3.7) | 35.4 (±5.2) | 30.6 (±5.5) | |
Smoker | 4 (57.1) | 3 (75.0) | 7 (63.6) | |
Diabetes | 2 (28.6) | 3 (75.0) | 5 (45.5) | |
insulin | 1 (14.3) | 1 (25.0) | 2 (18.2) | |
Dyslipidemia | 4 (57.1) | 1 (25.0) | 5 (45.5) | |
COPD | 1 (14.3) | 1 (25.0) | 2 (18.2) | |
PAD | 3 (42.9) | 1 (25.0) | 4 (36.4) | |
AF | 1 (14.3) | 0 (0) | 1 (9.1) | |
Previous stroke | 1 (14.3) | 0 (0) | 1 (9.1) | |
Kidney failure | 10 (90.1) | |||
I | 1 (14.3) | 0 (0) | 1 (9.1) | |
II | 5 (71.4) | 3 (75) | 8 (72.7) | |
III | 0 (0) | 1 (25.0) | 1 (9.1) | |
IV | 0 (0) | 0 (0) | 0 (0) | |
Ejection fraction | 57.3 (±6.4) | 62.5 (±5.0) | 59.2 (±6.2) | |
Previous myocardial infarction | 4 (57.1) | 2 (50.0) | 6 (54.5) | |
CCS | ||||
0 | 0 (0) | 0 (0) | 0 (0) | |
1 | 2 (28.6) | 0 (0) | 2 (18.2) | |
2 | 1 (14.3) | 4 (100) | 5 (45.5) | |
3 | 3 (42.9) | 0 (0) | 3 (27.3) | |
4 | 1 (14.3) | 0 (0) | 1 (9.1) | |
NYHA functional class | ||||
I | 1 (14.3) | 2 (50.0) | 3 (27.3) | |
II | 3 (42.9) | 2 (50.0) | 5 (45.5) | |
III | 3 (42.9) | 0 (0) | 5 (45.5) | |
IV | 0 (0) | 0 (0) | 0 (0) | |
SYNTAX score | ||||
Previous PCI | 6 (85.7) | 2 (50.0) | 7 (63.6) | |
LAD | 3 (42.9) | 2 (50.0) | 5 (45.5) | |
RCX | 2 (28.6) | 1 (25.0) | 3 (27.3) | |
RCA | 5 (71.4) | 0 (0) | 5 (45.5) | |
Indication for surgery | ||||
ARCA | 0 (0) | 4 (100) | 4 (36.4) | |
In-stent re-stenosis | 4 (57.1) | 0 (0) | 4 (36.4) | |
failed PCI | 3 (42.9) | 0 (0) | 3 (27.3) | |
Urgency | ||||
elective | 6 (85.7) | 4 (100) | 10 (90.1) | |
urgent | 1 (14.3) | 0 (0) | 1 (9.1) | |
EuroScore II | 1.7 (±0.6) | 2.8 (±2.4) | 2.1 (±1.5) |
Variable | CAD (n = 7) | ARCA (n = 4) | Total (n = 11) | |
---|---|---|---|---|
Number/%/Mean ± SD | Number/%/Mean ± SD | Number/%/Mean ± SD | ||
Total surgical time (minutes) | 203.3 ± 58.5 | 172.8 ± 15.1 | 192.2 ± 48.6 | |
Total length of stay (days) | 7.3 ± 4.0 | 7.8 ± 1.5 | 7.5 ± 3.2 | |
Ventilation time (minutes) | 335.6 ± 97.4 | 385.5 ± 43.8 | 353.7 ± 83.1 | |
Successful revascularisation | 7 (100) | 4 (100) | 11 (100) | |
Wound infection | 1 (14.3) | 0 (0) | 1 (9.1) | |
Tansient time flow measurement | ||||
mL/min | 59.3 ± 43.2 | 62.8 ± 16.5 | 59.3 ± 34.7 | |
PI | 1.7 ±0.4 | 1.8 ± 0.3 | 1.8 ± 0.3 | |
In-hospital mortality | 0 (0) | 0 (0) | 0 (0) |
Variable | CAD (n = 7) | ARCA (n = 4) | Total (n = 11) | |
---|---|---|---|---|
Number/%/Mean ± SD | Number/%/Mean ± SD | Number/%/Mean ± SD | ||
Angina (CCS) | ||||
0 | 7 (100) | 3 (75) | 10 (90.1) | |
I | 0 (0) | 0 (0) | 0 (0) | |
II | 0 (0) | 1 (25) | 1 (9.1) | |
III | 0 (0) | 0 (0) | 0 (0) | |
IV | 0 (0) | 0 (0) | 0 (0) | |
Revascularization after surgery | 1 (14.3) | 1 (25) | 2 (18.2) | |
Re-hospitalization | 1 (14.3) | 0 (0) | 1 (9.1) | |
Alive | 7 (100) | 4 (100) | 11 (100) |
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Hecker, F.; von Zeppelin, M.; Van Linden, A.; Scholtz, J.-E.; Fichtlscherer, S.; Hlavicka, J.; Walther, T.; Holubec, T. Right-Sided Minimally Invasive Direct Coronary Artery Bypass: Clinical Experience and Perspectives. Medicina 2023, 59, 907. https://doi.org/10.3390/medicina59050907
Hecker F, von Zeppelin M, Van Linden A, Scholtz J-E, Fichtlscherer S, Hlavicka J, Walther T, Holubec T. Right-Sided Minimally Invasive Direct Coronary Artery Bypass: Clinical Experience and Perspectives. Medicina. 2023; 59(5):907. https://doi.org/10.3390/medicina59050907
Chicago/Turabian StyleHecker, Florian, Mascha von Zeppelin, Arnaud Van Linden, Jan-Erik Scholtz, Stephan Fichtlscherer, Jan Hlavicka, Thomas Walther, and Tomas Holubec. 2023. "Right-Sided Minimally Invasive Direct Coronary Artery Bypass: Clinical Experience and Perspectives" Medicina 59, no. 5: 907. https://doi.org/10.3390/medicina59050907