Long Term Outcome Of Hybrid Revascularization In Multi Vessels Coronary Artery Disease In A Single Institution Study.
Maria Cannoletta1, Alan Soo2, Rashmi Yadav1, Richard Trimlett1, Anthony De Souza1.
1Royal Brompton Hospital, London, United Kingdom, 2University Hospital Galway, Galway, Ireland.
OBJECTIVE: There is increasing interest in the hybrid coronary artery revascularization procedure combining the long term benefit of the left internal mammary graft to the LAD with PCI to the non-LAD vessels aiming to achieve complete revascularization for multi-vessel coronary disease. Here, we report our results of hybrid coronary revascularisation over a 15 years period.
METHODS: The hospital cardiac surgery database (PATS & EPR) was retrospectively reviewed over a period of 15 years and 9 months. Patient characteristics and outcome including mortality and post-operative complications are reported.
RESULTS: Between January 2000 to September 2016, a total of 178 patients underwent hybrid coronary revascularization. During this period, there were 2 conversions (1.1%) to sternotomy and conventional coronary surgery. There was no hospital mortality and no stroke. The overall complication rate was low with the most common complication being atrial fibrillation (4 patients, 2.2%) and acute kidney injury (5 patients, 2.8%). There was one case (0.6%) of reploration for bleeding, 2 cases of pneumonia (1.1%), 2 significant wound infections and 1 occlusion of the LIMA graft requiring PCI to LAD. 15 patients (8.4%) underwent a reverse hybrid procedure with PCI to the acute culprit lesion followed by endoACAB at a later date.
CONCLUSIONS: The hybrid coronary revascularisation approach combining EndoACAB to LAD and PCI to non LAD vessels is a safe procedure with excellent outcome.
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