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Percent of patients at Lankenau Medical Center having minimally invasive surgery for coronary bypass far exceeds other U.S. hospitals

Lankenau Medical Center January 25, 2023 Research News

Despite older population, long-term clinical outcomes for Lankenau Medical Center-pioneered procedure are as consistently strong as the nation’s top clinical trials. It shortens recovery.

Wynnewood, PA — In 2005, Francis Sutter, DO, Chief of Cardiac Surgery at Lankenau Medical Center, part of Main Line Health, pioneered an advancement in the field of coronary artery bypass surgery—offering an alternative approach to traditional open-heart surgery. Lankenau launched one of the nation’s first programs for minimally invasive, robotic-assisted cardiac bypass surgery, seeking to reduce risks and decrease long-term complications as well as dramatically cut recovery time.

Results presented last week by Main Line Health physician researchers at one of the world’s leading organizations for cardiothoracic surgeons showed the percentage of patients at Lankenau having bypass surgery performed robotically is nearly 50 times higher compared to the rest of the nation’s medical centers. The research also demonstrated that, despite an older patient population, Lankenau’s long-term outcomes over 16 years were consistent or better than those in groundbreaking international clinical trials.

Results were presented Saturday at the Society of Thoracic Surgeons (STS) annual meeting in San Diego by the Lankenau Institute for Medical Research (LIMR) study’s lead investigator. LIMR is Main Line Health’s research division.

“It’s gratifying to see these results place Lankenau at the leading edge,” said Sutter, who accompanied professor Aleksander Dokollari, MD, PhD, Lankenau cardiac surgery researcher and presenter at the event. “I began performing the robotic procedure in 2005 because the traditional open-heart method was often too traumatic for older patients. Even if you conducted the procedure flawlessly, they tended not to fare as well. We now know for certain that robotic bypass surgery not only gives them a better chance but allows patients to recover more quickly.”

In 2021, 54.9% of all coronary artery bypass procedures performed at Lankenau were done robotically, according to the most recent annual STS reporting data, compared to 1.2% performed nationally.

“These kinds of results are why cardiac specialists throughout the region refer coronary bypass patients to us,” said Katie Galbraith, MBA, FACHE, President, Lankenau Medical Center. “High volumes lead to better outcomes. Most importantly, we’re getting patients back to their daily activities, home to their families and back to work faster. I’m grateful to LIMR’s researchers for compiling and analyzing the data that illustrates we are national leaders in robotic coronary bypass surgery. I know our team is dedicated to only getting better.”

The team at Lankenau has performed more than 2,500 robotic bypass surgeries to date. Sutter has personally performed over 2,300 of them, more than any surgeon in the United States. Gianluca Torregrossa, MD, joined as the director of the Robotic Coronary Revascularization Program at Lankenau Heart Institute in 2021, with the goal to drive further innovation.

With minimally invasive coronary bypass surgery, patients get back to their daily lives in half the time compared to recovery from an open-heart procedure. The surgeon needs only three to four very small keyhole incisions for inserting the robotic arms and camera in between the ribs, and the heart is kept beating during the procedure. With the traditional bypass procedure, the surgeon makes a 10-inch chest incision and cuts through the breastbone. The patient is placed on a heart-lung machine and the patient’s heart is stopped. The vast majority of robotic and traditional bypass patients at Lankenau are taken off the ventilator before leaving the operating room. Most traditional bypass patients at other institutions are not.

Detailed results of the LIMR research are as follows:

  • The fifteen-year survival rate for Lankenau bypass patients was comparable to that found in the trial to which it was compared. Notably, the Lankenau patients on average were significantly older (71 years old) than those in the comparison trial (63).
  • The low percentage of surgeries free of major adverse events (death, myocardial infarction, need for repeated procedure) was comparable to trial results published in the New England Journal of Medicine despite the same average age difference.
  • Hospital complications such as postoperative atrial fibrillation and the need for transfusion due to bleeding were lower when compared to results of two trials.

As with traditional coronary artery bypass surgery, females in the general population undergoing robotic coronary bypass surgery had higher rates of blood transfusion, postoperative atrial fibrillation (irregular heart rhythm) and a higher risk of requiring repeat coronary intervention in the cardiac catheterization lab, the authors found. Women generally have a lower body mass index, which correlates with smaller coronary vessel size and, thus, potentially greater vulnerability to certain complications. The findings are in line with other clinical studies.

The other coauthors were Michel Pompeu Sá, MD, MSc, PhD; John Malin, DO; Serge Sicouri, MD; MaryAnn C. Wertan, RN; Basel Ramlawi, MD, chief of cardiothoracic surgery, Main Line Health; and Gianluca Torregrossa. The study reviewed data for all patients undergoing robotic bypass from 2005 to 2021.

Overall, long-term outcomes were comparable between robotic-assisted and traditional bypass surgery.

About Lankenau Medical Center

Lankenau Medical Center, a member of Main Line Health, has been devoted to the health and well-being of the community since 1860, with a founding mission to serve all those in need. Our continued dedication to service, compassionate patient care and superior clinical programs makes Lankenau a preferred destination for care by people throughout the Philadelphia region and beyond. Lankenau offers primary care, disease prevention and specialized medical and surgical management of all diseases and disorders, as well as access to clinical trials. As a 371-bed teaching and research hospital, Lankenau is committed to maintaining high-level expertise across all clinical areas and is consistently recognized for providing outstanding care. Lankenau is ranked in U.S. News & World Report's Best Hospitals 2022–23 in the top three in the Philadelphia region, top six in Pennsylvania and top 50 in the nation for obstetrics and gynecology. Lankenau is rated as high performing in the following specialties: Cardiology & Heart Surgery, Orthopedics, Pulmonology & Lung Surgery, Urology. Lankenau is rated as high-performing in the following procedures and conditions: Aortic Valve Surgery, Back Surgery (spinal fusion), Chronic Obstructive Pulmonary Disease (COPD), Colon Cancer Surgery, Diabetes, Heart Attack, Heart Bypass Surgery, Heart Failure, Hip Fracture, Hip Replacement, Knee Replacement, Kidney Failure, Lung Cancer Surgery, Pneumonia, Transcatheter Aortic Valve Replacement (TAVR). Lankenau has achieved The Joint Commission's Gold Seal of Approval for stroke care and breast cancer care and is one of the nation's Top Performing Hospitals for heart attack, heart failure, pneumonia and surgical care. Lankenau Medical Center was rated a top performer in the Centers for Medicare & Medicaid Services' (CMS) Overall Hospital Quality Star Rating. Lankenau has also earned the highest distinction for excellence in nursing care, the American Nurses Credentialing Center Magnet® designation.

About Lankenau Institute for Medical Research

Lankenau Institute for Medical Research (LIMR) is a nonprofit biomedical research institute located on the campus of Lankenau Medical Center and is part of Main Line Health. Founded in 1927, LIMR's mission is to improve human health and well-being. Faculty and staff are devoted to advancing innovative new approaches to formidable medical challenges, including cancer, cardiovascular disease, gastrointestinal disorders and autoimmune diseases, such as diabetes and arthritis. LIMR's principal investigators conduct basic, preclinical and translational research, using their findings to explore ways to improve disease detection, diagnosis, treatment and prevention. They are committed to extending the boundaries of human health through technology transfer and training of the next generation of scientists and physicians.

About Main Line Health

Founded in 1985, Main Line Health is a not-for-profit health system serving Philadelphia and its western suburbs. Main Line Health's commitment—to deliver advanced medicine for treating and curing disease, playing an important role in prevention and disease management as well as training physicians and other health care providers—reflects our intent to be the region's premier choice for clinical care, research, and education. A team of nearly 13,000 employees and more than 2,000 physicians care for patients throughout the Main Line Health System.

At Main Line Health's core are four of the region's most respected acute care hospitals—Lankenau Medical Center, Bryn Mawr Hospital, Paoli Hospital and Riddle Hospital—as well as one of the nation's premier facilities for rehabilitative medicine, Bryn Mawr Rehabilitation Hospital.

Main Line Health also includes Mirmont Treatment Center for drug and alcohol recovery; Main Line Health HomeCare & Hospice, which includes skilled home health care, hospice and home infusion services; Main Line Health Centers, primary and specialty care, lab and radiology, and other outpatient services located in Broomall, Collegeville, Concordville, Exton, King of Prussia and Newtown Square; Lankenau Institute for Medical Research, a biomedical research organization; and Main Line HealthCare, one of the region's largest multispecialty physician networks.

Main Line Health is the recipient of numerous awards for quality care, and service, including U.S. News & World Report's Best Hospitals, System Magnet® designation; the nation's highest distinction for nursing excellence and the Mid-Atlantic Alliance for Performance Excellence (MAAPE) Excellence Award. Main Line Health is committed to creating an environment of diversity, respect, equity, and inclusion, has proudly received awards in this area and has embraced the American Hospital Association's #123forEquity Pledge to Act to eliminate disparities in care. We are dedicated to advancing patient-centered care, education, and research to help patients stay healthy and live their best lives.

For more information, visit mainlinehealth.org and connect with us on social media:

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Larry Hanover
Communications Manager, LIMR
Office: 484.476.8425
[email protected]