Early outcomes of minimally invasive hybrid coronary revascularization

Vigneshwar Bakthavachalam, M. M. Yusuf
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Abstract

Background: Coronary artery bypass graft (CABG) surgery has been the gold standard for the treatment of coronary artery disease over the years. It is recommended for patients with multi-vessel coronary artery disease, left main disease, diabetics, severe left ventricular dysfunction, unsuitable anatomy for percutaneous coronary intervention (PCI), and failed PCI. The usage of the left internal mammary artery (LIMA) in the CABG to the left anterior descending (LAD) artery has proven to be superior compared to PCI. Minimally invasive hybrid coronary revascularization (MIHCR) is gaining growing interest. Methods:  This is a hospital-based prospective observational study with 200 patients followed up for a period of 30 days. This study aims to assess the early outcomes of MIHCR in the Indian population. Results: The 30-day mortality was comparable to other studies, and the number of days in the ICU and hospital stay was shorter than the routine CABG. There was no incidence of a wound infection or stroke. Blood product usage and the need for repeat revascularization and re-exploration were less. The short-term outcomes were promising. Conclusions: MIHCR has excellent short-term results and is safer than conventional OPCABG, as it is less invasive and avoids midline sternotomy. It also reduces the incidence of stroke and lesser usage of blood products, promoting early return of patients to their routine activities.
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微创杂交冠状动脉血运重建术的早期疗效
背景:多年来,冠状动脉旁路移植(CABG)手术一直是治疗冠状动脉疾病的金标准。多血管冠状动脉疾病、左主干疾病、糖尿病、严重左心室功能障碍、解剖结构不适合经皮冠状动脉介入治疗(PCI)以及 PCI 治疗失败的患者都建议采用这种手术。在左前降支(LAD)动脉的 CABG 中使用左乳内动脉(LIMA)已被证明优于 PCI。微创混合冠状动脉血运重建术(MIHCR)越来越受到关注: 这是一项基于医院的前瞻性观察研究,对 200 名患者进行了为期 30 天的随访。本研究旨在评估印度人群中微创杂交冠状动脉再通术的早期疗效:结果:30 天死亡率与其他研究结果相当,重症监护室和住院天数比常规 CABG 短。没有发生伤口感染或中风。血液制品用量较少,重复血管重建和再次探查的需要也较少。短期疗效良好:MIHCR的短期疗效很好,而且比传统的OPCABG更安全,因为它创伤更小,避免了胸骨中线切开术。它还降低了中风的发生率,减少了血液制品的使用,促进患者早日恢复日常活动。
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