Estudo prospectivo e randomizado da revascularização do miocárdio minimamente invasiva com dissecção da artéria torácica interna esquerda por videotoracoscopia robótica / Robotic left internal mammary artery harvesting for single vessel minimally invasive coronary bypass: a randomized controlled trial

AUTOR(ES)
FONTE

IBICT - Instituto Brasileiro de Informação em Ciência e Tecnologia

DATA DE PUBLICAÇÃO

14/10/2011

RESUMO

Objective: The aim of this study was to compare the patency of left internal mammary artery (LIMA) robotically harvested for left anterior descendent (LAD) artery minimally invasive bypass with conventional LIMA to LAD off-pump bypass. Method: From 2007 to 2010, 36 patients were randomized to either LIMA robotically harvested to LAD artery minimally invasive bypass or standard LIMA to LAD off-pump bypass. Patients assigned to robotic group underwent robotic endoscopic harvesting of LIMA with the AESOP system followed by a small left thoracotomy in the 4th intercostal space for off-pump LAD bypass. Patients assigned to standard group underwent full median sternotomy, open LIMA harvesting followed by off-pump LAD bypass. Transit time flow measurement was used for intraoperative evaluation of LIMA to LAD patency. After a mean 24-month follow-up, Multislice Computed Tomography was used to evaluate LIMA to LAD midterm patency. Results: The mean LIMA harvesting time in robotic group was 50.1 ± 11.2 min vs. 22.7 ± 3.3 min in conventional group. There was no significant difference in intraoperative LIMA to LAD flow between robotic and conventional groups (46.17 ± 20.11 mL/min vs. 48.61 ± 23.42 mL/min, p=0.86). There were no significant differences in incidence of wound infection (0 vs. 2, p=0,48) and reoperation for bleeding (0 vs. 1, p=1.00) between robotic and conventional groups respectively. In robotic group, Multislice CT revealed patent LIMA graft in 100% patients vs. 94.1% patients in conventional group (p=1.00). There was no mortality in the study group. Conclusions: Minimally invasive LAD bypass using LIMA graft robotically harvested was safe and feasible. Early and mid-term LIMA patency was similar between both techniques

ASSUNTO(S)

angiografia coronária/métodos artéria torácica interna coronary angiography/methods coronary artery bypass off-pump coronary disease/surgery doença das coronárias/cirurgia ensaio clínico controlado aleatório flowmeters fluxômetros mammary arteries patência vascular ponte de artéria coronária sem circulação extracorpórea procedimentos cirúrgicos minimamente invasivos randomized controlled trial robótica robotics spiral computed surgical procedures minimally invasive tomografia computadorizada espiral tomography vascular patency

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