초록접수 현황
| 14F-059 | 구연 발표 |
A Single Center Experience of Robot-assisted
Minimally Invasive Coronary Artery Bypass Grafting
유재석, 김준범, 정성호, 주석중, 정철현, 이재원
울산대학교 의과대학 서울아산병원 흉부외과학교실
Background : To review our single center experience of robot-assisted minimally invasive coronary artery bypass grafting(CABG) using AESOP(Automated Endoscopic System for Optimal Positioning) 3000 and the Da Vinci Surgical System (including South Korea's first total endoscopic CABG[TECAB] performed by a Korean cardiac surgeon).
Methods : From August 2002 to August 2014, a total of 122 patients underwent robot-assisted minimally invasive CABG at Asan Medical Center. Of these, 39 patients underwent AESOP-assisted minimally invasive direct CABG(MIDCAB), 79 patients underwent da Vinci-assisted MIDCAB, and 4 patients underwent da Vinci-assisted TECAB. We reviewed these cases and analyzed the early and midterm clinical outcomes.
Results : Median age was 58 years(interquartile range[IQR]: 50-66 years), 93 patients (76.2%) were male, and the mean left ventricular ejection fraction was 58.1%. 29 patients(23.8%) were New York Heart Association functional class III or IV, and 12 patients(9.8%) underwent previous percutaneous coronary intervention. 1 vessel disease was in 59.3%, 2 vessel disease was in 30.5%, and 3 vessel disease was in 10.2%.
Robot-assisted minimally invasive CABG was performed successfully in all patients with no intraoperative conversion to sternotomy. The number of distal anastomosis was 1 in 86 patients(70.5%), 2 in 29 patients(23.8%), and ≥3 in 7 patients(5.7%). The mean time required for internal thoracic artery(ITA) harvest was 34.9±12.5 minutes. During the ITA harvest, vessel injury occurred in 1 case(0.8%).
No in-hospital death occurred, but there were 3 re-operations for ITA graft kinking. The length of intensive care unit stay was 1.6±1.1 hours and the median duration of hospital stay was 5 days (IQR: 3-17 days).
At a median of 66.7 months (IQR: 23.4-98.3 months), the graft patency rate was 98.4%(120/122).
Conclusion : Robot-assisted minimally invasive CABG is technically feasible and efficacious. Muti-vessel graft anastomosis is also possible. Special attention to graft positioning is needed.
Methods : From August 2002 to August 2014, a total of 122 patients underwent robot-assisted minimally invasive CABG at Asan Medical Center. Of these, 39 patients underwent AESOP-assisted minimally invasive direct CABG(MIDCAB), 79 patients underwent da Vinci-assisted MIDCAB, and 4 patients underwent da Vinci-assisted TECAB. We reviewed these cases and analyzed the early and midterm clinical outcomes.
Results : Median age was 58 years(interquartile range[IQR]: 50-66 years), 93 patients (76.2%) were male, and the mean left ventricular ejection fraction was 58.1%. 29 patients(23.8%) were New York Heart Association functional class III or IV, and 12 patients(9.8%) underwent previous percutaneous coronary intervention. 1 vessel disease was in 59.3%, 2 vessel disease was in 30.5%, and 3 vessel disease was in 10.2%.
Robot-assisted minimally invasive CABG was performed successfully in all patients with no intraoperative conversion to sternotomy. The number of distal anastomosis was 1 in 86 patients(70.5%), 2 in 29 patients(23.8%), and ≥3 in 7 patients(5.7%). The mean time required for internal thoracic artery(ITA) harvest was 34.9±12.5 minutes. During the ITA harvest, vessel injury occurred in 1 case(0.8%).
No in-hospital death occurred, but there were 3 re-operations for ITA graft kinking. The length of intensive care unit stay was 1.6±1.1 hours and the median duration of hospital stay was 5 days (IQR: 3-17 days).
At a median of 66.7 months (IQR: 23.4-98.3 months), the graft patency rate was 98.4%(120/122).
Conclusion : Robot-assisted minimally invasive CABG is technically feasible and efficacious. Muti-vessel graft anastomosis is also possible. Special attention to graft positioning is needed.
책임저자: 이재원
울산대학교 의과대학 서울아산병원 흉부외과학교실
연락처 : 유재석, Tel: 02-3010-1855 , E-mail : mdyoo77@gmail.com
