| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2002;73:1849-1855
© 2002 The Society of Thoracic Surgeons
a Heart Center Hamburg, Albertinen-Krankenhaus, Departments of Department of Cardiac Surgery, Hamburg-Othmarschen, Germany
b Department of Cardiac Anesthesiology, Hamburg-Othmarschen, Germany
c Department of Cardiology, Hamburg-Othmarschen, Germany
d Center for Cardiology, Hamburg-Othmarschen, Germany
Accepted for publication February 6, 2002.
* Address reprint requests to Dr Riess, Heart Center Hamburg, Albertinen-Krankenhaus, Abteilung für Herzchirurgie, Suentelstrasse 11a, 22457 Hamburg, Germany
e-mail: friedrich-christian.riess{at}albertinen.de
Background. Hybrid revascularization (HyR), combining minimally invasive left internal mammary artery (LIMA) bypass grafting to the left anterior descending coronary artery (LAD) and catheter interventional treatment of the remaining coronary lesions, avoids the disadvantages associated with cardiopulmonary bypass (CPB). We investigated the clinical follow-up of 57 patients with multivessel disease undergoing this procedure in the last 4 years.
Methods. Between January 1997 and January 2001, 57 consecutive patients (41 men and 16 women, aged 65.7 ± 7.9 years) with coronary artery disease (two-vessel, n = 34; three-vessel, n = 23) were treated with off-pump LIMA-to-LAD bypass combined with balloon angioplasty and stenting of the remaining significantly obstructed (> 50%) coronary vessels. Clinical follow-up data included a early postoperative and a 6-month control angiography and a patient interview in January 2001.
Results. All patients underwent LIMA-to-LAD bypass-grafting and balloon angioplasty in 72 coronary lesions without procedural-related complications. However, one early LIMA bypass occlusion was documented during coronary angiography. Postoperatively no deterioration of preexistent organ dysfunction was observed in any patient. The mean follow-up was 100.7 ± 37.9 weeks in 55 of 57 patients (97%). Control angiography 6 months after HyR (n = 34) revealed a patent LIMA bypass in 33 patients and 8 in-stent restenoses (> 50%) in the coronary arteries that were treated interventionally by re-PTCA (n = 6) or by conventional CABG (n = 1). In 1 patient medical treatment resulted in significant reduction of angina so no further intervention was considered necessary. After HyR 1 patient died 18 months later of an intracerebral hemorrhage. All other patients are alive and doing well.
Conclusions. Our results indicate that in selected patients with multivessel disease including left main stem stenosis HyR is an effective and secure procedure with excellent early and good midterm results. Especially elderly patients with severe concomitant diseases appear to benefit from this approach by avoiding CPB.
This article has been cited by other articles:
|
|
 |
|
  A. Colombo and A. Latib Surgeons and interventional cardiologists in a collaborative environment. J. Am. Coll. Cardiol., January 20, 2009; 53(3): 242 - 243. [Full Text] [PDF]
|
|
|
|
 |
|
 J. G. Byrne, M. Leacche, D. E. Vaughan, and D. X. Zhao Hybrid Cardiovascular Procedures J. Am. Coll. Cardiol. Intv., October 1, 2008; 1(5): 459 - 468. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Z. N. Kon, E. N. Brown, R. Tran, A. Joshi, B. Reicher, M. C. Grant, S. Kallam, N. Burris, I. Connerney, D. Zimrin, et al. Simultaneous hybrid coronary revascularization reduces postoperative morbidity compared with results from conventional off-pump coronary artery bypass. J. Thorac. Cardiovasc. Surg., February 1, 2008; 135(2): 367 - 375. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. R. Katz, F. Van Praet, D. de Canniere, D. Murphy, L. Siwek, U. Seshadri-Kreaden, G. Friedrich, and J. Bonatti Integrated Coronary Revascularization: Percutaneous Coronary Intervention Plus Robotic Totally Endoscopic Coronary Artery Bypass Circulation, July 4, 2006; 114(1_suppl): I-473 - I-476. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. A. Vassiliades Jr, J. S. Douglas, D. C. Morris, P. C. Block, Z. Ghazzal, S. T. Rab, and C. U. Cates Integrated coronary revascularization with drug-eluting stents: Immediate and seven-month outcome J. Thorac. Cardiovasc. Surg., May 1, 2006; 131(5): 956 - 962. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K D Dawkins, T Gershlick, M de Belder, A Chauhan, G Venn, P Schofield, D Smith, J Watkins, H H Gray, and Joint Working Group on Percutaneous Coronary Inter Percutaneous coronary intervention: recommendations for good practice and training Heart, December 1, 2005; 91(suppl_6): vi1 - vi27. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Davidavicius, F. Van Praet, S. Mansour, F. Casselman, J. Bartunek, I. Degrieck, F. Wellens, R. De Geest, H. Vanermen, W. Wijns, et al. Hybrid Revascularization Strategy: A Pilot Study on the Association of Robotically Enhanced Minimally Invasive Direct Coronary Artery Bypass Surgery and Fractional Flow Reserve-Guided Percutaneous Coronary Intervention Circulation, August 30, 2005; 112(9_suppl): I-317 - I-322. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Bonatti, T. Schachner, N. Bonaros, G. Laufer, C. Kolbitsch, J. Margreiter, P. Jonetzko, O. Pachinger, and G. Friedrich Robotic Totally Endoscopic Coronary Artery Bypass and Catheter Based Coronary Intervention in One Operative Session Ann. Thorac. Surg., June 1, 2005; 79(6): 2138 - 2141. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. J. Murphy, A. J. Bryan, and G. D. Angelini Hybrid Coronary Revascularization in the Era of Drug-Eluting Stents Ann. Thorac. Surg., November 1, 2004; 78(5): 1861 - 1867. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
