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Abstract
Background:
This is a Minimal invasive case series of coronary revascularization in selective group of patients treated with one stop Hybrid approach.
Objective:
Treating coronary heart disease is challenging and the option of revascularization is changing over time. We sought the idea to mix, best of both intervention and surgery.
Methods:
Patients were selected according to angiogram result with significant LAD lesion and secondary LCx and RCA lesion. Patient with severe obesity and severe pulmonary hypertension were excluded. Peripheral Fem-fem cannulation was carried out. 5-7cm submammary left-anterior incision was fashioned. IMA harvested in manual fashion under direct vision. Medtronic Octopus-Novo retractor was used. Progressive revascularization was performed in a proximal first-distal second-LIMA to LAD last sequence. Controlled angiography was carried out in the same session followed by PCI to the non-LAD lesion.
Results:
Total 18 cases were done in between October 2014 to June 2015. Average ejection fraction was 58.22%. Thoracotomy wound length 5.50±1.25cm. All patients’ recovery was uneventful. We had one case of conversion due to VF as a result of frustraneous stenting attempts of a bifurcational stenosis. Average length of hospital stays (LOS) 5±1 days. One patient needed LAD endarterectomy. On table IMA-graphy done, showed all patent vessel. Nil 30 days in hospital mortality. One patient needed intra-aortic balloon pump support and interval PCI.
Conclusions:
Stand-alone MIS coronary revascularization in McGinn technique and/or Hybrid completion presents powerful tools for coronary revascularization in the modern era in steep learning curve.
Keywords
Source Title
CPD Day, Bangladesh College of Physicians and Surgeons
Publisher
Bangladesh College of Physicians and Surgeons
Series/Report No.
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Date
2016-11-15
DOI
Type
Conference Paper