Treatment of Double Vessel Coronary Artery Disease by Totally Endoscopic Bypass Surgery and Drug-Eluting Stent Placement in One Simultaneous Hybrid Session
DOI:
https://doi.org/10.1532/HSF98.20051136Abstract
Hybrid coronary artery revascularization is a combination of minimally invasive coronary artery surgery and catheter-based coronary intervention. Hybrid procedures enable adequate revascularization of patients with multivessel coronary artery disease without complete opening of the chest and with the advantage of the most durable option, a left internal mammary artery (LIMA) graft is placed to the left anterior descending (LAD) artery. The hybrid concept is gaining renewed interest because totally endoscopic LIMA to LAD placement has become feasible and because drug-eluting stents in non-LAD targets may be competitive even for arterial bypass grafts. Simultaneous hybrid procedures would be desirable. We report on a case in which robotic totally endoscopic LIMA to LAD grafting using the da VinciTM telemanipulation system was combined with placement of a rapamycin coated stent to the right coronary artery in one single procedure.References
Mack MJ, Magovern JA, Acuff TA, et al. 1999. Results of graft patency by immediate angiography in minimally invasive coronary artery surgery. Ann Thorac Surg 68:383-9.nRiess FC, Schofer J, Kremer P, et al. 1998. Beating heart operations including hybrid revascularization: initial experiences. Ann Thorac Surg 66:1076-81.nBonatti J, Schachner T, Bonaros N, et al. 2005. Robotic totally endoscopic coronary artery bypass and catheter based intervention in one session. Ann Thorac Surg, 79:2138-41.nFriedrich GJ, Bonatti J, Dapunt OE. 1997. Preliminary experience with minimally invasive coronary-artery bypass surgery combined with coronary angioplasty. N Engl J Med 336:1454-5.nGoldstein JA, Safian RD, Aliabadi D, 1998. 1998. Intraoperative angiography to assess graft patency after minimally invasive coronary bypass. Ann Thorac Surg 66:1978-82.nWittwer T, Cremer J, Klima U, Wahlers T, Haverich A. 1999. Myocardial "hybrid" revascularization: intermediate results of an alternative approach to multivessel coronary artery disease. J Thorac Cardiovasc Surg 118(4):766-7.nAngelini GD, Wilde P, Salerno TA, Bosco G, Calafiore AM. 1996. Integrated left small thoracotomy and angioplasty for multivessel coronary artery revascularisation. Lancet 34:757-8.n