A hybrid alternative for high risk left main disease

Abstract

Percutaneous revascularization strategies for bifurcation disease of the left main are complex and carry significant risk. These risks are magnified in the setting of a left main which trifurcates. In a patient with complex ostial disease of two of the three limbs of a left main trifurcation, turned down for conventional bypass surgery, we report on a hybrid approach for complete revascularization, consisting of minimally invasive bypass grafting of the LAD combined with simultaneous drug eluting stent placement.

Heart Failure and “Inoperable” Aortic Stenosis: Staged Balloon Aortic Valvuloplasty and Aortic Valve Bypass

“…There are, however, several successful examples including surgical valve replacement combined with percutaneous coronary intervention, 11 hybrid coronary revascularization, 12 and an apical minimally invasive surgical approach to "percutaneous" aortic valve implant currently under investigation. 13 In our patient, two infrequently used procedures from different disciplines were combined sequentially to provide effective treatment for a patient with otherwise inoperable end-stage aortic stenosis.…”

Hybrid coronary revascularization for the treatment of left main coronary stenosis: A feasibility study

“…HCR represents a “best of both worlds” strategy combining the long‐term survival advantage of a LIMA‐LAD bypass and PCI with DES to non‐LAD targets [22]. The LIMA‐LAD graft bypasses not only the current LAD stenoses but also future lesions that may develop in the atherosclerosis‐prone proximal LAD [23].…”

The era of hybrid revascularization

“…Short‐ and mid‐term outcomes of mortality and morbidity have been favorably demonstrated . Several recent studies have shown comparable mortality, patency and incidences of major adverse cardiac event (MACE) rates when compared with conventional on‐ and off‐pump CABG surgery .…”