title: Feasibility and Early Safety of Single-Stage Hybrid Coronary Intervention and Valvular Cardiac Surgery.
abstract: BACKGROUND
  Hybrid percutaneous coronary intervention offers an alternative method of revascularization for high-risk surgical populations. We report the outcomes of a single-stage hybrid strategy in valvular cardiac surgery and explore its effects on operative risk and bleeding.
  
  
  METHODS
  In a hybrid operating room, 26 patients underwent hybrid surgery consisting of femoral arterial access, then coronary stenting followed by valve surgery, with appropriate heparin dosing. Clopidogrel (300 mg) was given on anesthesia induction in nonreoperative cases, or at the time of cross clamping (after stenting) for reoperative cases.
  
  
  RESULTS
  Mean follow-up was 680 ± 277 days. The planned coronary stenting and surgery was successful in all patients. Major cardiovascular and cerebrovascular adverse events occurred in 1 patient, with no inhospital deaths observed. No vascular complication or stent thrombosis was observed with the described antiplatelet regimen. Outcomes were comparable to those of standard bypass valve replacement surgery.
  
  
  CONCLUSIONS
  This study demonstrates the feasibility and early safety of a single-stage hybrid strategy with coronary stenting followed by valvular surgery in patients at increased surgical risk. Hybrid procedures may lower operative risk by eliminating or reducing the need for bypass grafting.
authors: Division of Cardiothoracic Surgery, New York-Presbyterian Hospital, Columbia University College of Physicians and Surgeons, New York, New York; Interventional Cardiology, New York-Presbyterian Hospital, Columbia University College of Physicians and Surgeons, New York, New York. Electronic address: ig2006@cumc.columbia.edu.
authors: Isaac
authors: I
authors: George
authors: Interventional Cardiology, New York-Presbyterian Hospital, Columbia University College of Physicians and Surgeons, New York, New York.
authors: Tamim M
authors: TM
authors: Nazif
authors: Division of Cardiothoracic Surgery, New York-Presbyterian Hospital, Columbia University College of Physicians and Surgeons, New York, New York.
authors: Bindu
authors: B
authors: Kalesan
authors: Division of Cardiothoracic Surgery, New York-Presbyterian Hospital, Columbia University College of Physicians and Surgeons, New York, New York.
authors: Jacob
authors: J
authors: Kriegel
authors: Division of Cardiothoracic Surgery, New York-Presbyterian Hospital, Columbia University College of Physicians and Surgeons, New York, New York.
authors: Halit
authors: H
authors: Yerebakan
authors: Interventional Cardiology, New York-Presbyterian Hospital, Columbia University College of Physicians and Surgeons, New York, New York.
authors: Ajay
authors: A
authors: Kirtane
authors: Interventional Cardiology, New York-Presbyterian Hospital, Columbia University College of Physicians and Surgeons, New York, New York.
authors: Susheel K
authors: SK
authors: Kodali
authors: Division of Adult Cardiac Surgery, New York University Langone Medical Center, New York, New York.
authors: Mathew R
authors: MR
authors: Williams
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D004452:Echocardiography; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome