Background Hybrid coronary revascularization （HCR） is an altemative coronary revascularization strategy that combines a minimally invasive, survival advantage of the left internal mammary artery （LIMA） -left anter...Background Hybrid coronary revascularization （HCR） is an altemative coronary revascularization strategy that combines a minimally invasive, survival advantage of the left internal mammary artery （LIMA） -left anterior descending （LAD） coronary artery bypass with less-invasive percutaneous coronary intervention （PCI） to non-LAD coronary lesions by using drug-eluting stents. We report our experience of hybrid minimally invasive approach in 15 patients. Methods From December 2012 to October 2013, 15 patients underwent revascularization of the left anterior descending artery through minimally invasive coronary artery bypass grafting （MIDCAB）. All patients by endoscopic assist beating heart coronary artery bypass grafting. Seven patients were scheduled for a hybrid procedure. Percutaneous coronary intervention of non- LAD was performed 3 to 5 days preoperatively. Demographic data, perioperative outcome, and annual follow-up were obtained from all the patients. Results In-hospital mortality was 6.67%. The rate of conversion to full median sternotomy was 13.3%. Ventilation time was 6.9 ± 5.1 h. Blood loss volume was 241 ± 67.8 mL. ICU stay was 21.3 ± 10.8 h. Hospital postoperative stay lasted for 7.5 ± 1.3 days. Prior to PCI patients showed 100% patent LIMA （Tables 3 and 4）. A mean follow-up was 8.5 months. One year graft patency rate was 100% （8/8 patients for 254-slice tomography）. Two patients required reintervention. Conclusions Minimally invasive hybrid coronary revascularization is a safe, feasible and efficacious approach with good results and should be performed in selected patients by surgeons with experience in minimally invasive bypass surgery plus collaboration with cardiologists, eluting stents.展开更多
文摘Background Hybrid coronary revascularization （HCR） is an altemative coronary revascularization strategy that combines a minimally invasive, survival advantage of the left internal mammary artery （LIMA） -left anterior descending （LAD） coronary artery bypass with less-invasive percutaneous coronary intervention （PCI） to non-LAD coronary lesions by using drug-eluting stents. We report our experience of hybrid minimally invasive approach in 15 patients. Methods From December 2012 to October 2013, 15 patients underwent revascularization of the left anterior descending artery through minimally invasive coronary artery bypass grafting （MIDCAB）. All patients by endoscopic assist beating heart coronary artery bypass grafting. Seven patients were scheduled for a hybrid procedure. Percutaneous coronary intervention of non- LAD was performed 3 to 5 days preoperatively. Demographic data, perioperative outcome, and annual follow-up were obtained from all the patients. Results In-hospital mortality was 6.67%. The rate of conversion to full median sternotomy was 13.3%. Ventilation time was 6.9 ± 5.1 h. Blood loss volume was 241 ± 67.8 mL. ICU stay was 21.3 ± 10.8 h. Hospital postoperative stay lasted for 7.5 ± 1.3 days. Prior to PCI patients showed 100% patent LIMA （Tables 3 and 4）. A mean follow-up was 8.5 months. One year graft patency rate was 100% （8/8 patients for 254-slice tomography）. Two patients required reintervention. Conclusions Minimally invasive hybrid coronary revascularization is a safe, feasible and efficacious approach with good results and should be performed in selected patients by surgeons with experience in minimally invasive bypass surgery plus collaboration with cardiologists, eluting stents.
