TCT-40 Long-Term Outcomes in Octogenarians After Robotic-Assisted Coronary Artery Bypass Grafting

In this study, we analyzed long-term outcomes in octogenarians undergoing robotic-assisted CABG. Methods All consecutive 500 octogenarians undergoing robotic-assisted LITA harvesting and CABG through a 4-cm left minithoracotomy from 2005 to 2021 were included. Hybrid coronary revascularization (HCR) consist in robotic-assisted CABG followed by PCI with DES in a non-LAD target within 7 days after the operation. Preoperative medical management in patients undergoing HCR consisted of beginning P2Y12 blockers medical therapy on the same day of PCI treatment. Results Preoperatively, mean age was 83 ± 2.9 years and mean STS-PROM was 3.6% (2.1%-6.6%). Intraoperatively, 478 patients (95.6%) received 1 LITA, 14 (12.8%) received bilateral ITA, and 8 (1.6%) received a saphenous venous graft. A total of 303 patients (60.6%) received multiple arterial revascularizations and 140 (28%) received HCR. Postoperatively, 2 patients (0.4%) experienced nonfatal stroke, 6 (1.2%) had reoperation for bleeding, and 12 (2.4%) had renal failure. There was no 30-day mortality, and 1 patient (0.2%) had PCI with DES on LITA-LAD anastomosis due to graft failure. Mean-follow-up was 2.9 years while incidence of all-cause death was 103 patients (20.6%), of MACCE 136 (27.2%), of stroke 8 (1.6%), of myocardial infarction 16 (3.2%), and of repeated intervention with stents 39 (7.8%). There was no repeated surgical intervention. Incidence of repeated PCI with DES for new vessel disease was 15/39 patients (38.4%)