Same-day combined percutaneous coronary intervention and coronary artery surgery.
BACKGROUND
Either percutaneous coronary intervention (PCI) or coronary artery bypass grafting can be chosen for the treatment of multiple-vessel coronary artery disease. We report the results of a hybrid procedure performed on the same day, combining PCI of the right coronary artery and internal mammary artery bypass grafting of the left coronary artery, for the treatment of diffuse extensive lesions.


RESULTS
Since January 2000, 70 patients (53 male, mean age 68.5 +/- 10 years) underwent this hybrid revascularization combining primary right coronary artery PCI and, within the next 16 h, left coronary artery grafting with left and/or right internal mammary artery. Thirty-one patients (98%) were treated on the same day. At a mean follow-up of 33 months (range: 2-70 months), 68 patients (97%) were asymptomatic at the time of writing. Three adverse events were reported: 2 were PCI-related, due to failure to take ticlopidine, and 1 was surgery-related, resulting in the patient's death during hospitalization.


CONCLUSIONS
These preliminary results for a same-day combined procedure in patients with diffuse multivessel coronary artery disease are encouraging. This strategy optimizes revascularization when patients are unstable or present very severe coronary lesions, which requiring rapid treatment and are not ideally suitable for PCI management alone.
Gilard
Martine
M
Department of Cardiology, University of Bretagne Occidentale, Brest, France. martine.gilard@chu-brest.fr
Bezon
Eric
E
Cornily
Jean C
JC
Mansourati
Jacques
J
Mondine
Philippe
P
Barra
Jean A
JA
Boschat
Jacques
J
D000368:Aged; D000556:Ambulatory Surgical Procedures; D015906:Angioplasty, Balloon, Coronary; D003324:Coronary Artery Disease / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects