Dokollari Aleksander, Bacchi Beatrice, Sicouri Serge, Cabrucci Francesco, Bonacchi Massimo, Spragan Danielle, Wertan Mary Ann C, Ghorpade Nitin, Kjelstrom Stephanie, Montone Georgia, Yamashita Yoshiyuki, Ramlawi Basel, Sutter Francis
Department of Cardiac Surgery Research, Lankenau Institute for Medical Research, Main Line Health, Wynnewood, PA 19096, USA.
Cardiac Surgery Division, St. Boniface Hospital, University of Manitoba, Winnipeg, MB R3T 2N2, Canada.
J Cardiovasc Dev Dis. 2025 Jan 10;12(1):21. doi: 10.3390/jcdd12010021.
The impact of long-term complications after robotic hybrid coronary revascularization (HCR), including persistent angina, repeat revascularization, and myocardial infarction (MI), remains limited. This study aims to determine the risk factors for coronary events after robotic HCR and their time-varying effects on outcomes.
We identified all consecutive patients who underwent robotic HCR at our institution. Baseline characteristics were explored as possible risk factors for angina, MI, and repeat revascularization with stents at any time during the follow-up.
A total of 875 patients (mean age 71.1 ± 11.1 years) were included. After a median follow-up of 3.32 years (IQR 1.18-6.34 years), angina occurred in 134 patients (15.3%), repeat revascularization with stents in 139 patients (15.8%), and MI in 36 patients (4.1%). The hazard rates for all outcomes increased with follow-up time, with a notable early rise around two years of follow-up for angina and, to a lesser extent, repeat revascularization. The risk factors were the lack of radial artery graft use, black race, diabetes, obesity, chronic obstructive pulmonary disease, low ejection fraction <50%, severe left main coronary artery stenosis (>50%), and more than three-vessel disease.
Optimization of modifiable periprocedural risk factors may positively impact long-term prognosis in patients undergoing robotic HCR.
机器人辅助杂交冠状动脉血运重建术（HCR）后长期并发症的影响，包括持续性心绞痛、再次血运重建和心肌梗死（MI），目前仍较为有限。本研究旨在确定机器人辅助HCR术后冠状动脉事件的危险因素及其对预后的时间变化影响。
我们纳入了在我院接受机器人辅助HCR的所有连续患者。探索基线特征作为随访期间任何时间发生心绞痛、MI和再次支架血运重建的可能危险因素。
共纳入875例患者（平均年龄71.1±11.1岁）。中位随访3.32年（IQR 1.18 - 6.34年）后，134例患者（15.3%）发生心绞痛，139例患者（15.8%）进行了再次支架血运重建，36例患者（4.1%）发生MI。所有结局的风险率均随随访时间增加，心绞痛在随访约两年时早期显著上升，再次血运重建的上升幅度较小。危险因素包括未使用桡动脉移植物、黑人种族、糖尿病、肥胖、慢性阻塞性肺疾病、低射血分数<50%、严重左主干冠状动脉狭窄（>50%）和三支以上血管病变。
优化可改变的围手术期危险因素可能对接受机器人辅助HCR的患者的长期预后产生积极影响。
