Hybrid cardiac surgical procedure

A hybrid cardiac surgical procedure in a narrow sense is defined as a procedure that combines a conventional surgical part (including a skin incision) with an interventional part, using some sort of catheter-based procedure guided by fluoroscopy (or other, e.g. CT or MRI) imaging in a hybrid OR without interruption. A wider definition includes a clinically connected succession of a catheter intervention and a surgical procedure with a time gap.

Surgical bypass grafting and percutaneous coronary artery revascularization are traditionally considered isolated options. A simultaneous hybrid approach may allow an opportunity to match the best strategy for a particular anatomic lesion. Thus hybrid coronary revascularization and MIDCAB (minimally invasive direct coronary artery bypass surgery) have been developed. Revascularization of the left anterior descending artery with the left internal mammary artery is by far the best treatment option in terms of long-term results. Integrating this therapy with percutaneous coronary angioplasty (hybrid procedure) offers multi-vessel revascularization through a mini-thoracotomy. Particularly in high risk patients, morbidity and mortality decreases in comparison to conventional surgery.

For people who undergo coronary artery bypass grafting, coronary imaging (completion angiography) for the routine evaluation of the bypass grafts may be reasonable.

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