International Society For Minimally Invasive Cardiothoracic Surgery

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Hybrid Coronary Artery Revascularization, 5 Year Patency And Clinical Follow-up
Roos Jong1, Stephanie Fox1, Nikolas Christidis1, Rodrigo Bagur1, Kumar Sridhar1, Shahar Lavi1, Ivan Iglesius1, Daniel Bainbridge1, Philip Jones1, Christopher Harle1, Marc Buijsrogge2, Michael Chu1, Patrick Teefy1, Bob Kiaii1.
1London Health Sciences Center, London, ON, Canada, 2University Medical Center, Utrecht, Netherlands.

Background: Hybrid coronary revascularization combines both surgical and percutaneous revascularization procedures. It offers a minimally invasive strategy of multivessel coronary artery disease and combines advantages of both. However, quantitative long-term patency and clinical outcomes remain understudied. The objective of this study is to assess clinical follow-up and graft and stent patency at 5-years follow-up. Methods: 121 patients from January 2004 to January 2014 were enrolled in this study at University Hospital, London Health Science Centre, London, Ontario, Canada. They underwent robotic-assisted minimally invasive coronary artery bypass graft of left internal thoracic artery to the left descending artery and percutaneous coronary intervention with stent of non-left anterior descending arteries in a single- or two-stage procedure. Patients underwent 5-year computed tomography angiography (CTA) and rest and stress myocardial perfusion scintigraphy (MPS-MIBI) follow-up. Patients also completed quality of life questionnaires at time of the scans. Results: 85% complete follow-up was achieved. 22 (18%) patients died (in 3 patients the cause of death was in cardiac nature). The CTA and MPS-MIBI scans show a left internal thoracic artery patency of 92% and stent patency of 91% with a mean follow-up from original procedure until scans of 7215 months. Freedom of repeat revascularization was 87%. Freedom of angina was 82% and patients reported a high quality of life postoperatively. Conclusions: Hybrid coronary revascularization is a safe and promising procedure. It foresees in a minimally invasive approach and results in complete revascularization with good long-term patency and high freedom from repeat revascularization and angina. Keywords: hybrid coronary revascularization - robotic-assisted CABG - percutaneous coronary intervention - long-term follow-up


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