Hybrid revascularization using percutaneous coronary intervention and robotically assisted minimally invasive direct coronary artery bypass surgery.
Hybrid revascularization (HR) combines staged percutaneous coronary intervention (PCI) on stenoses in the non-left anterior descending (LAD) territories with minimally invasive direct coronary artery bypass (MIDCAB) using the left internal thoracic artery (LITA) to the LAD. The LITA-to-LAD graft, which has a 5-year patency rate of 95%, is the major determinant of the long-term survival for patients. Thus, HR aims to perform full revascularization without compromising the survival advantage of the LITA-to-LAD graft, while preserving the minimally invasive advantages associated with the percutaneous treatment of symptomatic coronary stenoses. We investigated whether HR was a valid alternative to conventional coronary artery bypass graft surgery in patients with multivessel coronary artery disease. We also present our early experiences with HR using a combined approach of advanced PCI and robotically-assisted MIDCAB.
Lee
Michael S
MS
Cardiovascular Intervention Center, Cedars-Sinai Medical Center, 8631 W. Third St., Room 415E, Los Angeles, CA 90048, USA. michaelslee@pol.net
Wilentz
James R
JR
Makkar
Raj R
RR
Singh
Varinder
V
Nero
Tom
T
Swistel
Daniel
D
Belsley
Scott J
SJ
Simon
Claude
C
Rametta
Salvatore
S
DeRose
Joseph
J
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000379:methods*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D005240:Feasibility Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D012371:Robotics; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left