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3 . 2022

The preliminary experience of exoscope-assisted coronary artery bypass grafting: technical features and results

Abstract

Aim. To evaluate the feasibility and immediate flowmetric, angiographic and clinical results of coronary artery bypass grafting using microsurgical technique and exoscope in a preliminary study.

Material and methods. 18 patients with ischemic heart disease after coronary bypass surgery using microsurgical technique were enrolled in the study. All of the patients were randomly assigned in two groups. In the first group, all surgeries were performed using exoscope (n=9); in the second group, all surgeries were performed using operating microscope (n=9).

Results. 29 and 32 distal anastomoses with coronary arteries were performed in first and second groups, respectively. No intergroup differences in mean blood flow velocity and pulsatility index (PI) were detected by transit-time floumetry. In both groups all distal anastomosis were widely patent according CT-angiography on 7-th day after operations. The duration of cross-clumped time was significantly higher in the first group and was 61 (53; 69) minutes versus 48 (41; 55) minutes in the second group (p=0.047). No hospital death, strokes, repeat revascularizations, myocardial infarctions and postoperative bleeding requiring resternotomy were observed. All patients in the first and second groups were discharged at 10 (9; 12) and 12 (11; 14) postoperative days, respectively (p=0.052).

Conclusion. The results of the preliminary study demonstrated feasibility and safety of exoscope-assisted coronary artery bypass grafting. Comparative analysis with the results of microscope-assisted coronary artery bypass grafting showed the comparability of angiographic, functional and clinical outcomes of operations. Despite the small number of observations, the data obtained suggest that the technology of exoscope-stereoscopic imaging may occupy a certain niche in coronary surgery in the future. Further randomized trials are needed to determine the place and role of exoscope-stereoscopic systems in coronary surgery.

Keywords:coronary artery bypass grafting; exoscope; operating microscope; microsurgery

Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
For citation: Semchenko A.N., Yavny V.Ya., Emeshkin M.I., Bogdanov I.G., Rosseikin E.V. The preliminary experience of exoscope-assisted coronary artery bypass grafting: technical features and results. Clinical and Experimental Surgery. Petrovsky Journal. 2022; 10 (3): 38–47. DOI: https://doi.org/10.33029/2308-1198-2022-10-3-38-47  (in Russian)

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CHIEF EDITOR
CHIEF EDITOR
Sergey L. Dzemeshkevich
MD, Professor (Moscow, Russia)

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