Background

• Proven success in other domains

• Cardiac surgery adoption is limited due to complexity and safety concerns.

• Robotically assisted MIDCAB is minimally invasive → ideal procedure for ERAS

Objective

Exploring the feasibility and safety of an ERAS-Day 0 protocol in elected MIDCAB patients to enhance recovery and improve patient outcomes.

Methods

Study design: Subgroup analysis of a monocentric, prospective observational study

Patient selection:

• Elective single-vessel MIDCAB (morning case, uneventful procedure)

• Age > 18 years

• No COPD or lung disease, no diabetes mellitus, BMI < 35 kg/m2

• EuroSCORE II ≤ 3%

Readiness for ward transfer: Modified Aldrete Score

Nurse/patient ratio: PACU = 1/3, cardiac ward = 1/8

Conclusion

The ERAS-Day 0 program appears safe and feasible for carefully selected MIDCAB patients. Strict patient selection is essential to ensure safety and early recovery success Tailored ERAS strategies remain key to meeting individual recovery needs. Telemonitoring has potential to improve patient safety and ensure seamless follow-up. ‣ Two patients were supported by moveUP, a digital health app currently being evaluated in our department. As a preliminary study, these findings require validation in larger, controlled cohorts before broader implementation. “Less is more” may define the future of enhanced recovery in cardiac surgery.