title: Robotic-enhanced coronary surgery in octogenarians.
abstract: Robotic-enhanced minimally invasive direct coronary artery bypass grafting surgery (RE-MIDCAB) is based on the use of a robotic console and instrumentation for the dissection of the left internal thoracic artery (LITA). The LITA to left anterior descending (LAD) artery anastomosis is subsequently constructed through a mini thoracotomy. The purpose of this study is to present our experience of RE-MIDCAB outcomes in elderly patients.
  
  
  
  From 2002 until 2015, 44 octogenarians (the mean age of 82.9 years) underwent RE-MIDCAB. The mean logistic EuroSCORE was 9.2. The majority of the patients were male with a medical history of hypertension, dyslipidaemia and previous coronary interventions. Of these patients 25% underwent RE-MIDCAB combined with percutaneous coronary intervention (PCI) for the treatment of multi-vessel disease (hybrid revascularization).
  
  
  
  All RE-MIDCABs and combined 'hybrid' PCI procedures were successfully completed. The mean intensive care unit (ICU) and hospital stay were 1.6 days and 10.9 days, respectively. There was 1 in-hospital mortality (2.3%). After an average follow-up period of 29.2 months, 5 patients required repeat revascularization procedures (9.1%). Mortality on follow-up was estimated at 25.6%.
  
  
  
  Our report suggests that considering the age and frailty of the octogenarian population, RE-MIDCAB is a feasible and safe procedure which is associated with acceptable mid-term results.
authors.affiliation: Department of Surgery, Division of Cardiac Surgery , St. Michael's Hospital, University of Toronto , Toronto , Canada.
authors.forename: Apostolos
authors.initials: A
authors.lastname: Roubelakis
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, OLV Clinic Aalst, Belgium.
authors.forename: Filip
authors.initials: F
authors.lastname: Casselman
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, OLV Clinic Aalst, Belgium.
authors.forename: Johan
authors.initials: J
authors.lastname: van der Merwe
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, OLV Clinic Aalst, Belgium.
authors.forename: Bernard
authors.initials: B
authors.lastname: Stockman
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, OLV Clinic Aalst, Belgium.
authors.forename: Ivan
authors.initials: I
authors.lastname: Degrieck
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, OLV Clinic Aalst, Belgium.
authors.forename: Frank
authors.initials: F
authors.lastname: Van Praet
mesh_terms: D000369:Aged, 80 and over; D001530:Belgium / Q000453:epidemiology; D001026:Coronary Artery Bypass / Q000379:methods*; D003324:Coronary Artery Disease / Q000401:mortality / Q000601:surgery*; D005260:Female; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D008297:Male; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D065287:Robotic Surgical Procedures / Q000379:methods*; D016896:Treatment Outcome
keywords: Coronary disease; Minimal invasive surgery; Octogenarian