title: Robotic Total Arterial Off-Pump Coronary Artery Bypass Grafting: Seven-Year Single-Center Experience and Long-Term Follow-Up of Graft Patency.
abstract: BACKGROUND
  Coronary artery bypass grafting (CABG) is the gold-standard treatment for coronary artery disease, but the long-term benefits of robotic CABG remain unclear.
  
  
  METHODS
  Between January 2007 and November 2014, 240 consecutive patients (187 male and 53 female, average age 59 years) underwent robotic off-pump CABG with the da Vinci Surgical System (Intuitive Surgical, Sunnyvale, CA) in our center. Totally endoscopic coronary artery bypass (TECAB) (n = 100) or mini-thoracotomy coronary artery bypass (MINICAB) (n = 140) grafting was performed with skeletonized internal mammary arteries (IMA). Patients were followed up and graft patency was assessed every 6 months by coronary angiography or 64-multi-slide computed tomographic angiography.
  
  
  RESULTS
  All cases were completed without conversion to median sternotomy or cardiopulmonary bypass. A total of 237 single IMA grafts (98.3%) and 4 bilateral IMA grafts (1.7%) were used. No operative mortality was observed. Hybrid revascularization of non-left anterior descending vessels was performed in 24 patients (10%). No death, stroke, or myocardial infarction occurred in the follow-up of 41.1 ± 12.9 months. All grafts were patent before discharge. The IMA graft patency was 97.1% in TECAB and 96.4 % in MINICAB over 3 years (up to 91 months) postoperatively.
  
  
  CONCLUSIONS
  Robotic off-pump CABG using IMA grafts is a safe and effective procedure in selected patients. The long-term outcome and patency of IMA grafts are excellent.
authors.affiliation: Department of Cardiovascular Surgery, Institute of Cardiac Surgery, PLA General Hospital, Beijing, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Yang
authors.affiliation: Department of Cardiovascular Surgery, Institute of Cardiac Surgery, PLA General Hospital, Beijing, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Wu
authors.affiliation: Department of Cardiovascular Surgery, Institute of Cardiac Surgery, PLA General Hospital, Beijing, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Wang
authors.affiliation: Department of Cardiovascular Surgery, Institute of Cardiac Surgery, PLA General Hospital, Beijing, China.
authors.forename: Cangsong
authors.initials: C
authors.lastname: Xiao
authors.affiliation: Department of Cardiovascular Surgery, Institute of Cardiac Surgery, PLA General Hospital, Beijing, China.
authors.forename: Huajun
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Cardiovascular Surgery, Institute of Cardiac Surgery, PLA General Hospital, Beijing, China. Electronic address: gaochq301@yahoo.com.
authors.forename: Changqing
authors.initials: C
authors.lastname: Gao
mesh_terms: D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D003324:Coronary Artery Disease / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D065287:Robotic Surgical Procedures; D013997:Time Factors; D014654:Vascular Patency