Intrathecal Morphine for Analgesia in Minimally Invasive Cardiac Surgery: A Randomized, Placebo-controlled, Double-blinded Clinical Trial.

Background: Intrathecal morphine decreases postoperative pain in standard cardiac surgery. Its safety and effectiveness have not been adequately evaluated in minimally invasive cardiac surgery. The authors hypothesized that intrathecal morphine would decrease postoperative morphine consumption after minimally invasive cardiac surgery.

Angiographic patency after robotic beating heart totally endoscopic coronary artery bypass grafting facilitated by automated distal anastomotic connectors.

Objectives: Robotic totally endoscopic coronary artery bypass (TECAB) on the beating heart has been facilitated in our experience using distal coronary anastomotic connectors. In this study, we retrospectively reviewed graft patency in all robotic TECAB patients who underwent formal angiography at our current institution over a 5-year period.

Methods: Between July 2013 and June 2018, 361 consecutive patients underwent robotic beating-heart TECAB.

Benefit of Robotic Beating-Heart Totally Endoscopic Coronary Artery Bypass in Octogenarians.

Objective: An important advantage of robotic beating-heart totally endoscopic coronary artery bypass (TECAB) is early functional recovery, in which fragile patients like octogenarians (age >80 years) benefit most. The aim of this study was to investigate the safety and feasibility of TECAB in octogenarians.

Methods: We retrospectively reviewed patients undergoing TECAB from July 2013 to September 2017 at our institution.

Predictors of blood transfusion use in robotic beating-heart totally endoscopic coronary artery bypass with anastomotic connectors.

Background: We sought to identify the independent predictors of blood transfusion requirement in robotic beating-heart patients with totally endoscopic coronary artery bypass (TECAB).

Methods: We retrospectively reviewed patients undergoing TECAB with distal anastomotic connectors from July 2013 to May 2017 at our institution. The cohorts were divided into patients who received a blood transfusion (BT group) and patients who did not (non-blood transfusion [NBT] group).

Robotic cardiac surgery impact of a new patient-side assistant on outcomes.

Objective: Very few studies have focused on the experience of the patient-side assistant in robotic cardiac surgery. We investigated whether the retirement of a highly experienced robotic patient-side assistant and replacement with a new assistant had an effect on surgical outcomes.

Methods: In 4/2016, the established patient-side assistant retired after spending 8 months training a new patient-side assistant.

Robotic-Assisted Third-Time Redo Mitral Valve Replacement.

Robotic-assisted approaches in cardiac surgery are becoming an increasingly common form of minimally invasive surgery. Recent literature has shown robotic-assisted techniques to be superior to traditional sternotomy in infection rates, bleeding, length of hospital stay, and postoperative quality of life. Although there are growing numbers of centers performing robotic mitral valve (MV) surgery, this approach is usually reserved for first-time MV repair.

Robotic Multivessel Endoscopic Coronary Bypass: Impact of a Beating-Heart Approach With Connectors.

Background: Most robotic coronary bypass operations are single-vessel procedures. Very few centers perform totally endoscopic coronary artery bypass (TECAB), and even fewer perform multivessel grafting endoscopically. We hypothesized that a robotic beating-heart approach using distal anastomotic connectors facilitates multivessel TECAB with similar safety and efficacy to single-vessel TECAB.

Hybrid coronary revascularization: Midterm outcomes of robotic multivessel bypass and percutaneous interventions.

Objective: The purpose of this study was to investigate the outcomes of patients undergoing advanced hybrid coronary revascularization, defined as robotic beating-heart multivessel totally endoscopic coronary artery bypass combined with percutaneous coronary intervention.

Methods: This is a retrospective study. Among 308 consecutive patients who underwent totally endoscopic coronary artery bypass, 57 who underwent advanced hybrid coronary revascularization (mean age, 65.

Robotic Beating Heart Totally Endoscopic Coronary Artery Bypass in Higher-Risk Patients: Can It be Done Safely?

Objective: Patients with a high Society of Thoracic Surgeons (STS) predicted risk of mortality undergoing coronary artery bypass surgery are known to have worse outcomes. Less invasive approaches have been shown to improve morbidity and mortality for these patients. In this study, we examined perioperative outcomes in higher-risk patients undergoing robotic totally endoscopic beating heart coronary artery bypass surgery.

Is robotic beating heart totally endoscopic coronary artery bypass feasible for BMI > 35 morbidly obese patients?

Background: We investigated the outcomes of morbidly obese patients after robotic beating heart totally endoscopic coronary artery bypass (BH-TECAB).

Methods: This is a retrospective single center study. From July 2013 to December 2016, the outcomes of patients undergoing BH-TECAB were reviewed.

Does Robotic Beating Heart Connector Totally Endoscopic Coronary Artery Bypass Bridge the Gender Gap in Coronary Bypass Surgery?

Objective: Previous studies have shown that women carry a higher risk of morbidity and mortality after coronary artery bypass surgery. We investigated gender differences in risk factors and outcomes in our patients undergoing robotic beating heart connector totally endoscopic coronary artery bypass.

Methods: From July 2013 to April 2017, patients undergoing connector totally endoscopic coronary artery bypass were reviewed.

Morbid Obesity Does not Increase Morbidity or Mortality in Robotic Cardiac Surgery.

Objective: Morbid obesity (body mass index ≥ 35 kg/m) usually confers a higher perioperative risk in cardiac surgery. Robotic cardiac surgery may have many advantages for these high-risk patients.

Methods: We retrospectively reviewed patients undergoing robotic cardiac surgery from July 2013 to April 2017 at our institution.

Redo Robotic Endoscopic Beating Heart Coronary Bypass (TECAB) After Previous TECAB.

Redo-totally endoscopic coronary artery bypass (TECAB) after previous TECAB to our knowledge has never been reported in the literature. We present a case report of a 65-year-old gentleman who underwent a second beating-heart TECAB with the right internal mammary artery (IMA) to the obtuse marginal branch, following previous TECAB (left IMA-diagonal/left anterior descending). An extensive experience in robotic coronary operation and anastomotic devices contributed to the successful outcome in this patient.