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How to BYPASS to a better quality of life: Determining and improving clinical and patient-centred outcomes after totally endoscopic cardiac surgery
No full textIntroduction
Totally endoscopic coronary artery bypass grafting (TECAB) is a minimally
invasive approach to achieve surgical revascularisation through a minimally
invasive approach. Still, data regarding non-robotic TECAB is limited. This report
presents the results of a TECAB technique using long-shafted instruments, defined
as Endo-CABG, from a single-centre experience in 1500 consecutive patients.
Methods
A total of 1500 patients underwent Endo-CABG between January 2016 and
February 2023. Data were collected retrospectively, and patients were followed
up for one year. The primary outcome of this study was major adverse cardiac
and cerebrovascular events (MACCE)-free survival. Secondary efficacy outcomes
were graft failure and mortality. Furthermore, we analysed factors influencing
long-term freedom from MACCE and all-cause mortality.
Results
The mean age was 68 [61-75] years, of which 193 (12.87%) were octogenarians.
Multivessel disease was present in 1409 (93.93%) patients, and the mean
EuroSCORE II was 1.64% [1.09-2.92]. All patients underwent complete arterial
revascularisation with bilateral internal mammary grafting in 88.47%. Graft failure
occurred in 1.80% of cases after one year (n=27). Thirty-day mortality was
1.73% (n=26), one-year survival was 94.7% (95%CI:93.5-95.9%), and 1-year
MACCE-free survival was 91.7% (95%CI:90.2-93.2%). Younger age, good left
ventricular ejection fraction, absence of arterial hypertension, and absence of
urgent surgery were significantly associated with 1-year MACCE-free survival.
Conclusions
Endo-CABG appears to be a safe procedure, achieves surgical revascularisation,
and provides good outcomes regarding graft failure and major adverse cardiac
and cerebrovascular events at one year, while age, left ventricular ejection fraction, arterial hypertension, and urgency were associated with one-year
outcomes.Yilmaz Alaaddin zat mee in de jur
How to BYPASS to a better quality of life: Determining and improving clinical and patient-centred outcomes after totally endoscopic cardiac surgery
No full textIntroduction
Totally endoscopic coronary artery bypass grafting (TECAB) is a minimally
invasive approach to achieve surgical revascularisation through a minimally
invasive approach. Still, data regarding non-robotic TECAB is limited. This report
presents the results of a TECAB technique using long-shafted instruments, defined
as Endo-CABG, from a single-centre experience in 1500 consecutive patients.
Methods
A total of 1500 patients underwent Endo-CABG between January 2016 and
February 2023. Data were collected retrospectively, and patients were followed
up for one year. The primary outcome of this study was major adverse cardiac
and cerebrovascular events (MACCE)-free survival. Secondary efficacy outcomes
were graft failure and mortality. Furthermore, we analysed factors influencing
long-term freedom from MACCE and all-cause mortality.
Results
The mean age was 68 [61-75] years, of which 193 (12.87%) were octogenarians.
Multivessel disease was present in 1409 (93.93%) patients, and the mean
EuroSCORE II was 1.64% [1.09-2.92]. All patients underwent complete arterial
revascularisation with bilateral internal mammary grafting in 88.47%. Graft failure
occurred in 1.80% of cases after one year (n=27). Thirty-day mortality was
1.73% (n=26), one-year survival was 94.7% (95%CI:93.5-95.9%), and 1-year
MACCE-free survival was 91.7% (95%CI:90.2-93.2%). Younger age, good left
ventricular ejection fraction, absence of arterial hypertension, and absence of
urgent surgery were significantly associated with 1-year MACCE-free survival.
Conclusions
Endo-CABG appears to be a safe procedure, achieves surgical revascularisation,
and provides good outcomes regarding graft failure and major adverse cardiac
and cerebrovascular events at one year, while age, left ventricular ejection fraction, arterial hypertension, and urgency were associated with one-year
outcomes.Yilmaz Alaaddin zat mee in de jur
Totally Endoscopic Valve-in-Valve Procedure: Implantation of Perceval Prosthesis in Trifecta Ring
No full textQuality of life in patients undergoing minimally invasive cardiac surgery: a systematic review
No full textOBJECTIVE: Minimally invasive procedures have been developed to reduce surgical trauma after cardiac surgery. Clinical recovery is the main focus of most research. Still, patient-centred outcomes, such as the quality of life, can provide a more comprehensive understanding of the impact of the surgery on the patient's life. This systematic review aims to deliver a detailed summary of all available research investigating the quality of recovery, assessed with quality of life instruments, in adults undergoing minimally invasive cardiac surgery. METHODS: All randomised trials, cohort studies, and cross-sectional studies assessing the quality of recovery in patients undergoing minimally invasive cardiac surgery compared to conventional cardiac surgery within the last 20 years were included, and a summary was prepared. RESULTS: The randomised trial observed an overall improved quality of life after both minimally invasive and conventional surgery. The quality of life improvement in the minimally invasive group showed a faster course and evolved to a higher level than the conventional surgery group. These findings align with the results of prospective cohort studies. In the cross-sectional studies, no significant difference in the quality of life was seen except for one that observed a significantly higher quality of life in the minimally invasive group. CONCLUSIONS: This systematic review indicates that patients may benefit from minimally invasive and conventional cardiac surgery, but patients undergoing minimally invasive cardiac surgery may recover sooner and to a greater extent. However, no firm conclusion could be drawn due to the limited available studies. Therefore, randomised controlled trials are needed.status: Publishe
Evaluation of patient-centered and clinical outcomes after minimally invasive cardiac surgery: an observational cohort study
No full textEvaluation of patient-centered and clinical outcomes after minimally invasive cardiac surgery: an observational cohort study
No full textEvaluation of patient-centered and clinical outcomes after minimally invasive cardiac surgery: an observational cohort study
No full textTotally endoscopic coronary artery bypass grafting: experience in 1500 patients
No full textOBJECTIVES Totally endoscopic coronary artery bypass grafting (TECAB) is a minimally invasive approach to achieve surgical revascularization through a minimally invasive approach. Still, data regarding non-robotic TECAB are limited. This report presents the results of a TECAB technique using long-shafted instruments, defined as Endo-CABG, from a single-centre experience in 1500 consecutive patients. METHODS One thousand and five hundred patients underwent Endo-CABG between January 2016 and February 2023. Data were collected retrospectively, and patients were followed up for 1 year. The primary outcome of this study was major adverse cardiac and cerebrovascular events (MACCE)-free survival. Secondary efficacy outcomes were graft failure and mortality. Furthermore, we analysed factors influencing long-term freedom from MACCE and all-cause mortality. RESULTS The mean age was 68 [61-75] years, of which 193 (12.87%) were octogenarians. Multivessel disease was present in 1409 (93.93%) patients, and the mean EuroSCORE II was 1.64 [1.09-2.92] %. All patients underwent full arterial revascularization with bilateral internal mammary grafting in 88.47%. Graft failure occurred in 1.80% of cases after 1 year (n = 27). Thirty-day mortality was 1.73% (n = 26), 1-year survival was 94.7% (95% CI: 93.5-95.9%; n = 26) and 1-year MACCE-free survival was 91.7% (95% CI: 90.2-93.2%). Age, left ventricular ejection fraction, arterial hypertension and urgency were significantly associated with 1-year MACCE-free survival. CONCLUSIONS Endo-CABG appears to be a safe procedure, achieves surgical revascularization and provides good outcomes regarding graft failure and MACCE at 1 year, while age, left ventricular ejection fraction, arterial hypertension and urgency were associated with 1-year outcomes
Aortic Valve Replacement: Totally Endoscopic versus Mini-Sternotomy
No full text(1) Background: The development of totally endoscopic aortic valve replacement has the potential to enhance clinical results compared to mini-sternotomy. To our knowledge, no comparison between these two techniques has been conducted before. Therefore, the objective of this retrospective study is to examine the results after both totally endoscopic and mini-sternotomy approaches. (2) Methods: This study covered all elective patients who underwent isolated aortic valve replacement, either totally endoscopically (n = 392) or through a mini-sternotomy (n = 323), between 2013 and 2021. Multivariable analysis was used to account for baseline variations between the two groups. All data were retrospectively gathered and analysed. The primary objective of this study was the one-year mortality rate. (3) Results: The mean aortic cross-clamping and cardiopulmonary bypass times were significantly longer in the totally endoscopic approach (cross-clamping: 43.73 +/- 13.71 min and 61.93 +/- 16.76 min, p-value < 0.001; CPB time: 64.86 +/- 23.02 min and 93.23 +/- 23.67 min, p-value < 0.001). However, perioperative bleeding was lower (706.40 +/- 542.77 mL and 444.50 +/- 515.84 mL, p-value < 0.001). The primary objective, one-year survival, did not significantly differ between both groups (Mini-AVR: 94.5% vs TEAVR: 93.3%, p-value = 0.520). (4) Conclusions: Our results show that totally endoscopic aortic valve replacement has comparable clinical results compared to aortic valve replacement through mini-sternotomy.This research received no external fundin
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