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Robotically assisted coronary artery bypass graft surgery versus drug‐eluting stents for patients with stable isolated proximal left anterior descending disease
Author(s) -
Li Shuanglei,
Zhang Huajun,
Xiao Cangsong,
Wang Rong,
Wu Yang
Publication year - 2021
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.15433
Subject(s) - medicine , conventional pci , cardiology , percutaneous coronary intervention , stroke (engine) , angina , myocardial infarction , revascularization , coronary artery disease , stenosis , drug eluting stent , artery , unstable angina , surgery , mechanical engineering , engineering
Objective To compare the midterm outcomes of patients with isolated left anterior descending disease (iLAD) who underwent robotically assisted coronary artery bypass graft (R‐CABG) and percutaneous coronary intervention (PCI) with drug eluting stents (DES). Method Clinic data was collected in 223 patients who underwent R‐CABG in our hospital between July, 2007 to November, 2014. Cardiology Database System of our hospital was used to identify 4047 patients who underwent PCI with DES for LAD lesion between April, 2011 to November, 2014. Total 496 patients received DES and 108 patients underwent R‐CABG after screening. Patients were propensity matched into 108 R‐CABG and DES pairs according to vital statistic. Mortality, myocardial infarction (MI), stroke, repeat target lesion revascularization (r‐TLR), main adverse cardiac and cerebral events (MACCE), and angina relief were compared across pairs. Result Kaplan–Meier estimates for R‐CABG and DES had no significant difference in mortality ( p = 1.00), MI ( p = .32), Stroke ( p = .80), and MACCE ( p = .47), but the rate of r‐TLR ( p = .03) were lower in R‐CABG group. Patients who underwent R‐CABG had better angina relief ( p = .02), lower rate of arrhythmia ( p < .001), and recurrent angina ( p = .02) after operation compared patients received DES. Conclusion R‐CABG offers lower r‐TLR rate and better angina relief compared with DES for revascularization in patients with isolated proximal LAD stenosis and there was no difference in mortality, MI, stroke, and MACCE between them.