Evidence map›Paper›PMID 36466372›Full record

ArticleJTCVS techniques2022

Peripheral extracorporeal membrane oxygenation support expands the application of robot-assisted coronary artery bypass.

Vivek Patel, Zachary Gray, Mahboob Alam, Guilherme Vianna Silva, Leo Simpson, Kenneth Liao

Open access · goldAbstract read
In one paragraph

Article in JTCVS techniques, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact, top 92% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Vivek PatelDepartment of Cardiothoracic Surgery, Baylor College of Medicine, Houston, Tex.
Zachary GrayDepartment of Cardiothoracic Surgery, Baylor College of Medicine, Houston, Tex.
Mahboob AlamDepartment of Cardiology, Baylor College of Medicine, Houston, Tex.
Guilherme Vianna SilvaDepartment of Cardiology, Baylor College of Medicine, Houston, Tex.
Leo SimpsonDepartment of Cardiology, Baylor College of Medicine, Houston, Tex.
Kenneth LiaoDepartment of Cardiothoracic Surgery, Baylor College of Medicine, Houston, Tex.
Baylor College of Medicine · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: Robot-assisted coronary artery bypass (RCAB) is typically not offered to higher risk patients with reduced cardiopulmonary function, critical coronary artery disease, and challenging chest wall anatomy. In this study, we report the novel use of nonemergency intraoperative peripheral extracorporeal membrane oxygenation as partial cardiopulmonary support during RCAB for patients who were considered high-risk candidates for conventional CAB and at the same time not eligible for RCAB without cardiopulmonary support. Methods: Forty-five high risk patients (mean age, 68 years; Society of Thoracic Surgeons score, 6.27%; ejection fraction, 45%) underwent RCAB with nonemergency peripheral extracorporeal membrane oxygenation support for the following indications: inability to tolerate single-lung ventilation (n = 17; 38%), low ejection fraction <35% (n = 17; 38%), inadequate exposure of internal thoracic artery (n = 24; 53%), critical coronary artery disease (n = 16; 36%), and hemodynamic instability after anesthesia induction (n = 3; 7%). Following robotic internal thoracic artery takedown, all patients had beating heart minimally invasive direct CAB through a 2-inch minithoracotomy. Results: Up to 30 days, there were no strokes (0%), myocardial infarctions (0%), or access vessel complications (0%). One noncardiac related mortality (2.2%) was related to hemodialysis access issues in a patient with preexisting end-stage renal disease. One redo-CAB (2.2%) patient required sternotomy to locate the target vessel. Thirty-four (75.6%) patients were extubated within 6 hours of surgery. Conclusions: Our results examine the feasibility of using peripheral extracorporeal membrane oxygenation during RCAB for high-risk patients who otherwise had limited options. The use of peripheral extracorporeal membrane oxygenation in RCAB can potentially expand the surgical treatment options in high-risk coronary artery disease patients.

Indexed as

CAB, coronary artery bypassCTA, computed tomography angiogramECMOECMO, extracorporeal membrane oxygenationITA, internal thoracic arteryLAD, left anterior descendingLITA, left internal thoracic arteryMIDCABMIDCAB, minimally invasive direct coronary artery bypassminimally invasive cardiac surgeryRCAB, robot-assisted coronary artery bypassRITA, right internal thoracic arteryrobotic coronary artery bypassSTS, Society of Thoracic SurgeonsTEE, transthoracic echocardiogram

Identifiers

PMID36466372
PMCPMC9716230
OpenAlexW4226147590

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.