Integrated Coronary Revascularization

Abstract

Integrated revascularization treatment plans provide minimally invasive options for patients with multivessel coronary artery disease. This approach may be accomplished with no mortality, low perioperative morbidity, and excellent angiographic LIMA patency. The reintervention rate after PCI in this series was higher than that reported elsewhere and should be investigated further. The choice of suitable vessel, type of stent and timing of the treatment must be carefully considered before implementing this hybrid strategy.

Robotically Assisted Totally Endoscopic Coronary Bypass Surgery

“…An international multicenter trial reported the feasibility of robotically assisted TECAB with no mortalities or strokes. 38 In this study, early patency rates of robotically sutured left IMA grafts were encouraging, at 96.3%. Our group performed the first simultaneous robotic hybrid coronary interventions in which both TECAB and percutaneous coronary intervention were performed in a single session.…”

Hybrid Procedures Have Proven Clinical Utility and Are the Wave of the Future

“…26 -40,42-51 Being a strong reflection of operator experience, results from single-center series can vary considerably. Katz et al 36 acknowledged that although they achieved excellent perioperative results from a robotically mediated endoscopic approach in 27 patients, their reintervention rate exceeded that reported elsewhere. The exceptionally high restenotic rate of 26% (3 bare metal stents and 4 DES) likely reflects lesion complexity and operator experience and therefore must be interpreted with caution.…”

Hybrid coronary revascularization – techniques and outcome

“…Several groups have reported on successful application of TECAB in hybrid procedures since the mid 2000s [9,[14][15][16][17][18][19][20][21]. These papers clearly demonstrate that the robotic technique is reproducible.…”

“…As drug eluting stents were developed they were immediately used in hybrid coronary interventions [8,15,16,18,19] because improved short-and long-term results of the PCI part of the concept were expected. Drug eluting stents are currently used in the vast majority of hybrid coronary interventions [8,[23][24][25].…”