Minimally invasive direct coronary artery bypass grafting combined with percutaneous coronary intervention in the treatment of coronary heart disease

Objective To observe hybrid operations method that was minimally invasive direct coronary artery bypass grafting(MIDCAB) combined with percutaneous coronary intervention(PCI) in the treatment of coronary heart disease.Methods Thirty-two patients with coronary artery disease were treated with hybrid operations to achieve myocardial revascularization.Results Thirty-four grafts and 42 stents were implanted in 32 patients.These included 29 left internal mammary artery(LIMA) and 5 great saphenous vein grafts.Patients had a mean number of 2.3 myocardial revascularizations.All patients recovered without any reported deaths.Bypass blood flow was measured in 26 patients;mean blood flow of LIMA and great saphenous veins was 45 mL/min(SD=15 mL/min) and 58 mL/min(SD=16 mL/min).In a follow-up study of 29 patients,mean follow-up time was 2.6 years(SD=0.8 years,range:0.5 to 7.0 years).There were no reported late deaths or myocardial infarctions.Coronary CT scan and angiography were performed for 16 and 12 patients.Two patients had in-stent restenosis,and 1 patient had vascular occlusion of the great saphenous vein bypass graft.Conclusion The hybrid operation is minimally invasive,providing a rapid recovery with satisfactory long-term effects.It is effective for patients with severe multivessel coronary artery disease and non-responsive surgical operations or interventional therapy.