MANAGEMENT OF CAD: ROBOTIC AND HYBRID CABG
by Johannes Bonatti, MD FETCS Chief of Cardiothoracic Surgery
2
n=541
3
AXCOR AXCOR
Y RIMA
Dg LIMA LAD
WORLD’S FIRST TOTALLY ENDOSCOPIC QUADRUPLE BYPASS – ARRESTED HEART
TECAB 6/2001 - 4/2012 (n=601)
TECAB x 1
368
(61.2%)
TECAB x 2
199
(33.1%)
TECAB x 3
31
(5.2%)
TECAB x 4
3
(0.5%)
Endo-Cardioplegia 468 (77.4%) Beating Heart 133 (22.1%)
5
TECAB 6/2001 - 4/2012 (n=601)
Ventilation time (h)
9
(0-704)
ICU stay (h)
23 (11-1048)
Hospital stay (d)
6
(2-54)
Mortality
7
(1.2%)
6
Case
44 y.o. male, angina, family history of CAD and CABG Insulin dependent DM No other significant comorbidities Complex proximal LAD lesion RCA lesion amenable to PCI
Robotic AH-TECAB LIMA to LAD Heartport remote access perfusion Aortic balloon endo-occlusion
Intraoperative Angiogram
Intraop angiogram ICU stay 18h, Aspirin and Plavix started POD #0
LIMA LAD at PCI POD #2
PCI POD #2 hospital stay 4 days, back to work 3 weeks postop
SURGERY FIRST PCI FIRST SIMULTANEOUS
12
TECAB x 2 3 Weeks Postop