Follow-up experience with coronary hybrid-revascularisation

Background: Minimally invasive direct coronary artery bypass (MIDCAB) grafting is an accepted therapeutical option especially in multimorbid, elderly and reoperative patients with single vessel disease. To expand the benefits of MIDCAB to patients with multivessel disease, an interdisciplinary hybrid approach was recently introduced. This study comprises follow-up information by coronary re-angiography. Methods: 35 patients (29 male, 6 female, mean age 56.7 +/- 17 years) underwent a "hybrid" revascularisation using a primary MIDCAB procedure with LIMA bypass to LAD followed by staged angioplasty and stenting of additional coronary lesions. Follow-up was performed in the outpatient department at the time of control angiography. Results: After an uneventful hybrid revascularisation without procedure related complications, all patients were alive and angina-free with normal-stress ECG after 11.4 +/- 7.7 months postoperatively. Control angiography (n = 14) revealed a patency rate of 100% (LIMA bypasses) and 93.3% (PTCA), respectively. Conclusions: The "hybrid" approach to myocardial revascularisation is safe and effective for complete revascularisation in selected patients with multivessel involvement. Especially elderly and reoperative patients with significant comorbidity may benefit from hybrid procedures avoiding cardiopulmonary bypass and midsternotomy