Does preoperative multislice computed tomography predict operative times in total endoscopic coronary artery bypass grafting?
OBJECTIVE
Multislice computed tomography (MSCT) is currently discussed as a potential tool for procedure planning in endoscopic heart surgery. We aimed to assess the influence of various thoracic measurements on operative times in arrested heart totally endoscopic coronary artery bypass grafting (AHTECAB).


METHODS
34 patients (aged 59 years, 71% male) scheduled for AHTECAB were examined prospectively with ECG-gated 16-channel MSCT angiography of coronary arteries and internal mammary arteries. All AHTECABs were single LIMA to LAD bypass operations using the Da Vinci telemanipulator and the ESTECH remote access perfusion system.


RESULTS
The LIMA-LAD distances were: I (at origin of the first diagonal branch) 4.3 cm (2.5-6.0), II (aortic valve level) 3.7 cm (1.1-6.4), III (mitral valve level) 2.9 cm (0.7-5.0), and IV (basis cordis) 2.3 cm (0.6-4.3). The anterioposterior thoracic diameter was 12.4 cm (8.9-15.6), and the transverse diameter was 24.9 cm (21.1-26.8). LIMA-LAD distances I (P = .025, r = .396) and III (P = .042, r = .356) significantly correlated with the anastomotic time. Increased rotation of the heart to the left was associated with a decreased cardiopulmonary bypass time (p = .016, r = -.451).


CONCLUSIONS
These data suggest that MSCT has the potential to predict operative times in robotic AHTECAB.
Schachner
Thomas
T
Department of Cardiac Surgery, Innsbruck Medical University, Innsbruck, Austria. Thomas.Schachner@uibk.ac.at
Feuchtner
Gudrun
G
Bonaros
Nikolaos
N
Oehlinger
Armin
A
Gassner
Eva
E
Friedrich
Guy
G
Smekal
Alexander
A
Laufer
Guenther
G
Bonatti
Johannes
J
D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D004562:Electrocardiography; D004724:Endoscopy; D005260:Female; D006324:Heart Arrest, Induced; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008323:Mammary Arteries / Q000000981:diagnostic imaging* / Q000637:transplantation; D008875:Middle Aged; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011446:Prospective Studies; D012371:Robotics; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*