Coronary artery bypass surgery hybrid coronary revascularization

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Patient Information

Overview

Pathophysiology

Saphenous Vein Graft Disease
Other Non-Atherosclerotic Saphenous Vein Graft Diseases

Indications for CABG

Prognosis

Diagnosis

Imaging in the Patient Undergoing CABG

Chest X Ray

Angiography

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Goals of Treatment

Perioperative Management

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Electrocardiographic Monitoring
Pulmonary Artery Catheterization
Central Nervous System Monitoring

Surgical Procedure

Anesthetic Considerations
Intervention in left main coronary artery disease
The Traditional Coronary Artery Bypass Grafting Procedure (Simplified)
Minimally Invasive CABG
Hybrid coronary revascularization
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Varun Kumar, M.B.B.S. [2]

ACCF/AHA Guidelines for Hybrid Coronary Revascularization[1]

Class IIa

"1. Hybrid coronary revascularization (defined as the planned combination of LIMA-to-LAD artery grafting and PCI of ≥1 non-LAD coronary arteries) is reasonable in patients with 1 or more of the following[2][3][4][5][6][7][8][9][10] (Level of Evidence: B):

  • Limitations to traditional CABG, such as heavily calcified proximal aorta or poor target vessels for CABG (but amenable to PCI);
  • Lack of suitable graft conduits;
  • Unfavorable LAD artery for PCI (ie, excessive vessel tortuosity or chronic total occlusion)."
Class IIb

"1. Hybrid coronary revascularization (defined as the planned combination of LIMA-to-LAD artery grafting and PCI of ≥1 non-LAD coronary arteries) may be reasonable as an alternative to multivessel PCI or CABG in an attempt to improve the overall risk–benefit ratio of the procedures. (Level of Evidence: C) "

Guidelines Resources

  • 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery : A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines[1]

References

  1. 1.0 1.1 Hillis LD, Smith PK, Anderson JL, Bittl JA, Bridges CR, Byrne JG; et al. (2011). "2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". Circulation. doi:10.1161/CIR.0b013e31823c074e. PMID 22064599.
  2. Bonatti J, Schachner T, Bonaros N, Jonetzko P, Ohlinger A, Ruetzler E, Kolbitsch C, Feuchtner G, Laufer G, Pachinger O, Friedrich G (2008). "Simultaneous hybrid coronary revascularization using totally endoscopic left internal mammary artery bypass grafting and placement of rapamycin eluting stents in the same interventional session. The COMBINATION pilot study". Cardiology. 110 (2): 92–5. doi:10.1159/000110486. PMID 17971657. Retrieved 2011-12-14.
  3. Gilard M, Bezon E, Cornily JC, Mansourati J, Mondine P, Barra JA, Boschat J (2007). "Same-day combined percutaneous coronary intervention and coronary artery surgery". Cardiology. 108 (4): 363–7. doi:10.1159/000099110. PMID 17308384. Retrieved 2011-12-14.
  4. Holzhey DM, Jacobs S, Mochalski M, Merk D, Walther T, Mohr FW, Falk V (2008). "Minimally invasive hybrid coronary artery revascularization". The Annals of Thoracic Surgery. 86 (6): 1856–60. doi:10.1016/j.athoracsur.2008.08.034. PMID 19021994. Retrieved 2011-12-14. Unknown parameter |month= ignored (help)
  5. Kon ZN, Brown EN, Tran R, Joshi A, Reicher B, Grant MC, Kallam S, Burris N, Connerney I, Zimrin D, Poston RS (2008). "Simultaneous hybrid coronary revascularization reduces postoperative morbidity compared with results from conventional off-pump coronary artery bypass". The Journal of Thoracic and Cardiovascular Surgery. 135 (2): 367–75. doi:10.1016/j.jtcvs.2007.09.025. PMC 2962576. PMID 18242270. Retrieved 2011-12-14. Unknown parameter |month= ignored (help)
  6. Reicher B, Poston RS, Mehra MR, Joshi A, Odonkor P, Kon Z, Reyes PA, Zimrin DA (2008). "Simultaneous "hybrid" percutaneous coronary intervention and minimally invasive surgical bypass grafting: feasibility, safety, and clinical outcomes". American Heart Journal. 155 (4): 661–7. doi:10.1016/j.ahj.2007.12.032. PMC 2636970. PMID 18371473. Retrieved 2011-12-14. Unknown parameter |month= ignored (help)
  7. Vassiliades TA, Douglas JS, Morris DC, Block PC, Ghazzal Z, Rab ST, Cates CU (2006). "Integrated coronary revascularization with drug-eluting stents: immediate and seven-month outcome". The Journal of Thoracic and Cardiovascular Surgery. 131 (5): 956–62. doi:10.1016/j.jtcvs.2005.10.058. PMID 16678575. Retrieved 2011-12-14. Unknown parameter |month= ignored (help)
  8. Zhao DX, Leacche M, Balaguer JM, Boudoulas KD, Damp JA, Greelish JP, Byrne JG, Ahmad RM, Ball SK, Cleator JH, Deegan RJ, Eagle SS, Fong PP, Fredi JL, Hoff SJ, Jennings HS, McPherson JA, Piana RN, Pretorius M, Robbins MA, Slosky DA, Thompson A (2009). "Routine intraoperative completion angiography after coronary artery bypass grafting and 1-stop hybrid revascularization results from a fully integrated hybrid catheterization laboratory/operating room". Journal of the American College of Cardiology. 53 (3): 232–41. doi:10.1016/j.jacc.2008.10.011. PMID 19147039. Retrieved 2011-12-14. Unknown parameter |month= ignored (help)
  9. Angelini GD, Wilde P, Salerno TA, Bosco G, Calafiore AM (1996). "Integrated left small thoracotomy and angioplasty for multivessel coronary artery revascularisation". Lancet. 347 (9003): 757–8. PMID 8602013. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)
  10. Simoons ML (1996). "Myocardial revascularization--bypass surgery or angioplasty?". The New England Journal of Medicine. 335 (4): 275–7. doi:10.1056/NEJM199607253350409. PMID 8657245. Retrieved 2011-12-14. Unknown parameter |month= ignored (help)

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