Long-term outcomes of robotically assisted coronary artery bypass graft surgery versus drug eluting stent in patients with isolated left anterior descending disease

Objective To compare the long-term outcomes of robotically assisted coronary artery bypass graft (R-CABG) versus percutaneous coronary intervention (PCI) with drug eluting stents (DES) for patients with isolated left anterior descending disease(iLAD). Methods Clinical data were collected in 223 patients who underwent R-CABG in our hospital from April, 2007 to November, 2014. Cardiology Database System of our hospital was used to identify 4 047 patients who underwent PCI with DES for LAD lesion from April, 2011 to November, 2014. Total of 496 patients received DES and 108 patients underwent R-CABG were screened out. Patients were matched into 108 R-CABG and DES pairs by propensity score according to vital statistics. Mortality, incidence of myocardial infarction(MI), stroke, repeat target lesion revascularization(r-TLR), main adverse cardiac and cerebral events(MACCE) and angina relief were compared across pairs. Results Kaplan-Meier estimates for R-CABG and DES had no significant difference in mortality (P=1.000), incidence of MI (P=0.317 3), Stroke (P=0.796 3) and MACCE (P=0.465 2), but the rate of r-TLR (P=0.033 9) was lower in R-CABG group. Patients in R-CABG group had lower rates of arrhythmia (P=0.016 0) and recurrent angina (P=0.020 9) after operation compared with patients in DES group. Conclusion Although R-CABG patients had lower r-TLR rate and better angina relief compared with DES patients, there were no difference in mortality, occurence of MI, stroke, and MACCE between them.