Published on May 19, 2009, doi:10.1510/icvts.2009.203059
Interactive CardioVascular and Thoracic Surgery 2009;9:214.
Does obesity affect operative times and perioperative outcome of patients undergoing totally endoscopic coronary artery bypass surgery?
Dominik Wiedemann 1*,
Thomas Schachner 1,
Nikolaos Bonaros 1,
Felix Weidinger 1,
Christian Kolbitsch 1,
Guy J. Friedrich 1,
Gunther Laufer 1,
Johannes Bonatti 2
1 Innsbruck Medical University, Austria
2 University of Maryland, Baltimore, USA
* To whom correspondence should be addressed. E-mail: dominik.wiedemann{at}i-med.ac.at.
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Abstract |
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More and more patients undergoing coronary artery bypass grafting (CABG) are overweight. This patient group suffers from wound healing problems more often than normal-weight patients. Therefore, avoiding sternotomy in obese patients by using an endoscopic technique could be a promising approach. Robotic technology enables totally endoscopic coronary artery bypass grafting (TECAB) procedures. We investigated whether the intra-operative-times or perioperative-outcome after TECAB-procedure are negatively affected by obesity. Patients [n=127, 101 male, 26 female, median age 59 (31-77) years], undergoing arrested-heart TECAB procedure were enrolled. The median body mass index (BMI) in this patient cohort was 26 (19-38). In detail, 27 patients were normal weight (BMI 25 kg/m2), 67 patients were overweight (BMI 25.1-30 kg/m2), 29 patients were obese (BMI 30.1-33.9 kg/m2) and 4 patients were morbidly obese (BMI 34 kg/m2). There was no correlation between BMI (1) left internal mammary artery (LIMA) takedown-time [Spearman-rank correlation coefficient (R)=0.02; p=ns], (2) lipectomy and pericardiotomy-time (R=0.042, p=n.s.), (3) total operative-time (R=-0.083: p=ns), (4) cardiopulmonary-bypass-time (R=-0.012; p=ns), (5) aortic-endoocclusion-time (R=-0.055; p=ns), (6) mechanical-ventilation-time (R=0.001, p=ns), (7) length of ICU-stay (R=0.04; p=ns), (8) length of hospital-stay (R=-0.103; p=ns, or (9) occurrence of intra- and/or postoperative adverse events. In overweight, obese but also morbidly obese patients the TECAB procedure did not increase operative times or the rate of intra- or postoperative complications. This patient group, therefore, benefits from this less traumatic version of coronary surgery. Keywords: Obesity; Coronary artery disease; Coronary artery bypass grafting; Endoscopic surgery; Robotic surgery
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