Between 2001 and 2011, 484 patients underwent TECAB by 4 surgeons at 2 institutions. The median patient age was 60 years (range, 31-90), and the median European System for Cardiac Operative Risk Evaluation was 2 (range, 0-13). Single-vessel (n?=?334) and double-vessel (n?=?150) procedures were performed using the da Vinci, da Vinci S, and da Vinci Si robotic systems.
Compared with the single-vessel procedure, double-vessel TECAB required a longer operative time (median, 375 minutes; range, 168-795; vs median, 240; range, 112-605; P?<?.001) and had an increased conversion rate to a larger thoracic incision (31/150 [20.7 % ] vs 31/334 [9.3 % ]; P?<?.001). The median ventilation time was 10 hours (range, 0-288) for double-vessel versus 8 hours (range, 0-278) for single-vessel procedures (P?=?.006). The hospital stay was comparable, with 6?days (range, 2-27) for double-vessel TECAB and 6 days (range, 2-33) for single-vessel TECAB (P?=?.794). Perioperative mortality was 0.3 % (1/334) with single-vessel TECAB and 2.0 % (3/150) with double-vessel TECAB (P?=?.090). Freedom from major adverse cardiac and cerebral events at 5 years was similar after double- and single-vessel TECAB (73.5 % vs 83.1 % , P?=?.150). The 5-year survival was 95.8 % and 93.9 % (P?=?.708).
Double-vessel TECAB appears feasible and reproducible. The operative times were longer and the conversion rates to a larger thoracic incision were greater than with single-vessel TECAB. Also, the postoperative ventilation time was longer. Other perioperative morbidity and mortality and the recovery time and long-term clinical outcomes, however, were comparable.