title: Closed chest hybrid coronary revascularization for multivessel disease - current concepts and techniques from a two-center experience.
abstract: Hybrid coronary revascularization combining minimally invasive coronary surgery and percutaneous coronary intervention (PCI) allows sternal preserving treatment of multivessel coronary disease. The main principle of the technique includes placement of mammary artery graft to the left anterior descending coronary artery (LAD) and performance of PCI in non-LAD target vessels. This principle is based on increasing data showing equivalent results of PCI with coronary revascularization using saphenous vein grafts in selected patients. Providing that perioperative and long-term results are as good as the results of conventional surgical revascularization, this option seems to be quite appealing for patients and referring cardiologists. This concept has been designed to allow rapid rehabilitation and minimize periprocedural pain under concomitant preservation of the patient's body integrity. Robotically assisted endoscopic approaches for hybrid coronary revascularization set the pace for a closed-chest treatment of multivessel coronary disease. The time point of PCI, the use of different anticoagulation protocols as well as the stent selection are some of the variables, which affect outcome. We additionally report on the midterm results of 130 after-closed-chest hybrid-coronary procedures in two institutions. Hybrid procedures using robotic technology and PCI allow closed chest treatment of multivessel coronary artery disease. Single- and double-bypass grafts are feasible and simultaneous interventions can be performed. The overall safety of the procedure seems to be adequate and perioperative clinical results are satisfactory. Intermediate term survival and freedom from angina are excellent.
authors: Department of Cardiac Surgery, Innsbruck Medical University, Anichstrasse 35, A-6020 Innsbruck, Austria. nikolaos.bonaros@i-med.ac.at
authors: Nikolaos
authors: N
authors: Bonaros
authors: Thomas
authors: T
authors: Schachner
authors: Dominik
authors: D
authors: Wiedemann
authors: Felix
authors: F
authors: Weidinger
authors: Eric
authors: E
authors: Lehr
authors: David
authors: D
authors: Zimrin
authors: Guy
authors: G
authors: Friedrich
authors: Johannes
authors: J
authors: Bonatti
mesh_terms: D000328:Adult; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D003324:Coronary Artery Disease / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000379:methods*; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D018579:Patient Selection; D019990:Perioperative Care / Q000379:methods; D012371:Robotics / Q000379:methods