Robotic-Assisted Redo Coronary Artery Bypass Grafting: A Single-Center Experience.

Abstract

Purpose: To report our experience with robotic-assisted redo coronary artery bypass grafting (CABG).

Methods: This single-center retrospective study included patients undergoing robotic-assisted redo CABG between 2016 and 2023. Patient demographics and operative outcomes were compared with those of initial robotic-assisted CABG procedures performed during the same period.

Results: There were 12 patients undergoing robotic-assisted redo CABG, with a median age of 73 years. Compared to initial CABG patients (n = 1415), the Society of Thoracic Surgeons scores were significantly higher (median: 0.90 vs. 7.05, p <0.001) in the redo group. Six patients had de novo internal mammary artery (IMA) to left anterior descending (LAD) bypass, 4 had redo LAD bypass, and 2 had non-LAD bypass. Among the 10 patients with LAD bypass, 4 also underwent hybrid percutaneous coronary intervention. While operating room time (5.4 vs. 7.4 hours, p <0.001), postoperative lengths of stay (4.0 vs. 5.5 days, p = 0.02) and the need for blood transfusion (15% vs. 42%, p = 0.02) were significantly greater in the redo group compared to the initial group, there were no conversions to sternotomy, unplanned revascularization, or in-hospital mortality in the redo patients.

Conclusion: Robotic-assisted redo CABG demonstrated promising operative outcomes in appropriately selected patients despite the higher-risk cohort.