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Hybrid revascularization

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https://www.readbyqxmd.com/read/28338553/consequences-of-hybrid-procedure-addition-to-robotic-assisted-direct-coronary-artery-bypass
#1
Feras Khaliel, Vincenzo Giambruno, Michael W A Chu, Kumar Sridhar, Patrick Teefy, Bob B Kiaii
OBJECTIVE: Patients postcoronary artery revascularization surgery often receives blood product transfusion, which could delay their intensive care unit and hospital discharge. We investigated our robotic-assisted direct coronary artery bypass (RADCAB) transfusion rate to determine whether performing the minimal invasive coronary surgery with percutaneous coronary intervention in one stage would increase the incidence of blood transfusion, morbidity, and length of stay. METHODS: Between November 2003 and November 2015, 483 consecutive patients underwent RADCAB surgery...
March 23, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28338552/is-the-future-of-coronary-arterial-revascularization-a-hybrid-approach-the-canadian-experience-across-three-centers
#2
Vincenzo Giambruno, Ahmad Hafiz, Stephanie A Fox, Hugues Jeanmart, Richard C Cook, Feras H Khaliel, Patrick Teefy, Kumar Sridhar, Shahar Lavi, Rodrigo Bagur, Varinder K Randhawa, Ivan Iglesias, Philip M Jones, Christopher C Harle, Daniel Bainbridge, Michael W A Chu, Bob B Kiaii
OBJECTIVE: Hybrid coronary revascularization offers and combines the advantages of both surgical and percutaneous revascularization and eliminates at the same time the disadvantages of both procedures. The objective of this study was to assess graft and stent patency at 6 months, rate of bleeding, intensive care unit and hospital stay, rate of reintervention, and long-term clinical follow-up. METHODS: From March 2004 to November 2015, a total of 203 patients underwent robotic-assisted minimally invasive direct coronary artery bypass graft of the left internal thoracic artery to the left anterior descending artery and PCI of a non-left anterior descending vessel in a single or two stage, at three different centers...
March 23, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28329064/perioperative-outcomes-of-off-pump-minimally-invasive-coronary-artery-bypass-grafting-with-bilateral-internal-thoracic-arteries-under-direct-vision%C3%A2
#3
Keita Kikuchi, Xufa Chen, Makoto Mori, Atsushi Kurata, Liang Tao
OBJECTIVES: We previously introduced techniques to harvest and use the right internal thoracic artery in minimally invasive coronary artery bypass grafting (CABG) via a single left thoracotomy for revascularization with bilateral internal thoracic arteries (BITA). We report our short-term outcomes of patients who underwent minimally invasive CABG using BITA and a single internal thoracic artery (SITA). METHODS: Consecutive patients who underwent minimally invasive CABG using BITA or SITA at a Japanese medical center between February 2012 and December 2015 were reviewed retrospectively...
January 31, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28315181/update-on-the-management-of-chronic-total-occlusions-in-coronary-artery-disease
#4
REVIEW
Kathleen Kearney, Ravi S Hira, Robert F Riley, Arun Kalyanasundaram, William L Lombardi
PURPOSE OF THE REVIEW: Chronic total occlusions (CTOs) are found in about a third of patients with coronary artery disease (CAD) and can pose a significant challenge during percutaneous revascularization. However, advances in CTO percutaneous coronary intervention (PCI) strategies, devices, and algorithms have led to significant improvements in successful treatment of CTOs. This review summarizes current management of CTOs in the context of modern PCI techniques and current evidence. RECENT FINDINGS: The hybrid algorithm now provides a standardized, teachable approach to CTO PCI, and success rates are approximately 90% in experienced hands...
April 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/28314675/a-hybrid-strategy-with-bioresorbable-vascular-scaffolds-and-drug-eluting-stents-for-treating-complex-coronary-lesions
#5
Richard J Jabbour, Alfonso Ielasi, Akihito Tanaka, Massimo Leoncini, Bernado Cortese, Giulietta Grigis, Satoru Mitomo, Damiano Regazzoli, Gaetano Di Palma, Claudio Rapetto, Maurizio Tespili, Antonio Colombo, Azeem Latib
BACKGROUND: Due to the inherent limitations of current generation BVSs, complex coronary artery disease often contains BVS unsuitable segments. Our aim was to assess the feasibility of a hybrid approach using bioresorbable vascular scaffolds (BVSs) and drug-eluting stents (DESs) for the treatment of complex coronary artery lesions not suitable for a scaffolding only approach. METHODS: A retrospective multicenter cohort analysis was performed on patients with complex de novo or in-stent restenosis lesions treated with a hybrid BVS (Absorb BVS, Abbott Vascular, Santa Clara, CA) and DES strategy...
March 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28296045/one-year-outcomes-after-successful-chronic-total-occlusion-percutaneous-coronary-intervention
#6
W M Wilson, S J Walsh, A Bagnall, A T Yan, C G Hanratty, M Egred, E Smith, K G Oldroyd, M McEntegart, J Irving, H Douglas, J Strange, J C Spratt
We aimed to determine clinical outcomes 1 year after successful chronic total occlusion (CTO) PCI and, in particular, whether use of dissection and re-entry strategies affects clinical outcomes. Hybrid approaches have increased the procedural success of CTO percutaneous coronary intervention (PCI) but longer-term outcomes are unknown, particularly in relation to dissection and re-entry techniques. Data were collected for consecutive CTO PCIs performed by hybrid-trained operators from 7 United Kingdom (UK) centres between 2012 and 2014...
March 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28293511/de-novo-reconstruction-of-a-hybrid-patella-by-staged-fabrication-of-a-microvascular-bone-transplant-with-an-osteointegrated-prosthetic-socket
#7
Goetz A Giessler, Christian Hendrich
Total patellectomy is sometimes unavoidable but usually results in severely impaired function, pain, and instability in the affected knee. Any patellar prosthetic solutions rely on a certain amount of remaining bone and therefore are not applicable after total patellectomy. Traditionally, reconstruction of a neopatella by avascular or allogeneic bone grafts is hampered by mechanical failure, resorption, or infection. We developed a new, 3-stage approach to reconstruct a hybrid patella composed of a revascularized scapula tip transplant fabricated with a prosthetic socket...
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28288884/the-profile-of-circulating-matrix-metalloproteinases-in-patients-undergoing-lower-limb-endovascular-interventions-for-peripheral-arterial-disease
#8
Ioakeim T Giagtzidis, Nikolaos P Kadoglou, George Mantas, Aris Spathis, Konstantinos O Papazoglou, Petros Karakitsos, Christos D Liapis, Christos D Karkos
BACKGROUND: Matrix metalloproteinases (MMPs) play a significant role in the development and progression of atherosclerotic vascular disease. We aimed to document the profile of circulating MMPs in peripheral arterial disease (PAD) patients undergoing lower limb endovascular revascularization. METHODS: A total of 46 patients (37 male; mean age 66±11 years) undergoing elective lower limb percutaneous revascularization (angioplasty/stent) for symptomatic PAD were recruited from two vascular centers...
March 10, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28266098/characteristics-and-outcomes-of-patients-undergoing-percutaneous-coronary-intervention-within-1-year-of-coronary-artery-bypass-graft-surgery
#9
Divyesh Sharma, Mark A Kotowycz, Vinoda Sharma, Anirban Choudhury, William Chan, Xavier Freixa, Vladimír Džavík, Christopher B Overgaard
OBJECTIVES: The aim of this study was to examine the clinical and procedural outcomes of patients undergoing percutaneous coronary intervention (PCI) within 1 year of coronary artery bypass graft surgery (CABG). BACKGROUND: CABG is the preferred revascularization strategy for patients with complex coronary artery disease due to a lower rate of repeat revascularization. Despite advances in surgical technique and medical therapy, >5% of patients require repeat revascularization within 1 year of CABG...
March 7, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28242408/a-rare-entity-traumatic-thoracic-aortic-injury-in-a-patient-with-aberrant-right-subclavian-artery
#10
Hiten Mohanbhai Patel, Shubhabrata Banerjee, Shahzad Bulsara, Tapish Sahu, Virender K Sheorain, Tarun Grover, Rajiv Parakh
BACKGROUND: Aberrant right subclavian artery is an uncommon entity incidence ranging from 0.5-2.5%. Management of thoracic aortic injury in the presence of such anomalies can be a challenge. We present here a case of traumatic aortic injury which was incidentally found to have an asymptomatic aberrant right subclavian artery. The patient was managed by an endovascular repair of thoracic aortic injury with an endograft and a right carotid to subclavian artery bypass as a hybrid procedure...
February 24, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28104206/randomized-multicenter-trial-investigating%C3%A2-angiographic-outcomes-of%C3%A2-hybrid-sirolimus-eluting-stents-with%C3%A2-biodegradable-polymer-compared-with%C3%A2-everolimus-eluting-stents-with-durable%C3%A2-polymer-in-chronic-total-occlusions-the-prison-iv-trial
#11
Koen Teeuwen, René J van der Schaaf, Tom Adriaenssens, Jacques J Koolen, Pieter C Smits, José P S Henriques, Paul H M J Vermeersch, R Melvyn Tjon Joe Gin, Bastiaan E Schölzel, Johannes C Kelder, Jan G P Tijssen, Pierfrancesco Agostoni, Maarten J Suttorp
OBJECTIVES: The aim of this study was to investigate the efficacy and safety of the hybrid ultrathin-strut sirolimus-eluting stent (SES) with biodegradable polymer compared with the thin-strut everolimus-eluting stent (EES) with durable polymer in successfully recanalized chronic total occlusions (CTOs). BACKGROUND: The introduction of drug-eluting stents revolutionized the treatment of CTOs. However, limited data are available on new-generation drug-eluting stents with biodegradable polymer in CTOs...
January 23, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28031245/robotic-enhanced-coronary-surgery-in-octogenarians
#12
Apostolos Roubelakis, Filip Casselman, Johan van der Merwe, Bernard Stockman, Ivan Degrieck, Frank Van Praet
OBJECTIVES: Robotic-enhanced minimally invasive direct coronary artery bypass grafting surgery (RE-MIDCAB) is based on the use of a robotic console and instrumentation for the dissection of the left internal thoracic artery (LITA). The LITA to left anterior descending (LAD) artery anastomosis is subsequently constructed through a mini thoracotomy. The purpose of this study is to present our experience of RE-MIDCAB outcomes in elderly patients. METHODS: From 2002 until 2015, 44 octogenarians (the mean age of 82...
December 27, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27942403/the-future-of-off-pump-coronary-artery-bypass-grafting-a-north-american-perspective
#13
Bobby Yanagawa, Rashmi Nedadur, John D Puskas
Off-pump coronary artery bypass graft (OPCAB) is currently performed routinely in a minority of specialized centers and in many more centers, utilized only when a porcelain aorta mandates a no-touch aortic technique. The OPCAB literature can be summarized as follows: (I) large-scale randomized trials in relatively low risk patients that include surgeons with a range of experience demonstrating no consistent beneficial differences in major cardiovascular and cerebrovascular outcomes but lower transfusion rates and shorter length of stay, tempered by some reports of higher rates of incomplete revascularization and lower rates of long term graft patency; (II) smaller randomized controlled trials (RCTs) from highly specialized programs demonstrating equivalent or superior outcomes with OPCAB and similar completeness of revascularization and graft patency; and (III) observational data from large databases demonstrating a consistent benefit of OPCAB, especially in higher-risk patient subsets...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27928232/minimally-invasive-surgical-techniques-in-the-era-of-hybrid-coronary-revascularization-additional-benefits-for-the-elderly-patients
#14
Antonio Nenna, Mario Lusini, Salvatore Matteo Greco, Elvio Covino, Massimo Chello
No abstract text is available yet for this article.
October 2016: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/27834663/discordance-between-resting-and-hyperemic-indices-of-coronary-stenosis-severity-the-verify-2-study-a-comparative-study-of-resting-coronary-pressure-gradient-instantaneous-wave-free-ratio-and-fractional-flow-reserve-in-an-unselected-population-referred-for-invasive
#15
Barry Hennigan, Keith G Oldroyd, Colin Berry, Nils Johnson, John McClure, Peter McCartney, Margaret B McEntegart, Hany Eteiba, Mark C Petrie, Paul Rocchiccioli, Richard Good, Martin M Lindsay, Stuart Hood, Stuart Watkins
BACKGROUND: Distal coronary to aortic pressure ratio (Pd/Pa) and instantaneous wave-free ratio (iFR) are indices of functional significance of a coronary stenosis measured without hyperemia. It has been suggested that iFR has superior diagnostic accuracy to Pd/Pa when compared with fractional flow reserve (FFR).We hypothesized that in comparison with FFR, revascularization decisions based on either binary cutoff values for iFR and Pd/Pa or hybrid strategies incorporating iFR or Pd/Pa will result in similar levels of disagreement...
November 2016: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27759734/contemporary-techniques-for-coronary-cto-revascularization
#16
Vladimir Dedovic, Goran Stankovic
Despite permanent improvement in success rate and technical developments, chronic total occlusion (CTO) remains undertreated by percutaneous coronary intervention (PCI). Dedicated CTO operators from Japan, Europe and USA perform these procedures with success rate beyond 90%, but there is still huge gap between this group of specialists and broader population of PCI operators. Recently proposed CTO scores can be used for patients' selection according to the CTO operators' experience. Patients with low CTO Score values may be suitable for less experienced operators at the beginning of the CTO PCI learning curve, while more complex CTOs (higher CTO Score values) should be differed to CTO experts...
March 2017: Panminerva Medica
https://www.readbyqxmd.com/read/27727088/cardiac-surgery-or-interventional-cardiology-why-not-both-let-s-go-hybrid
#17
REVIEW
Nikolaos A Papakonstantinou, Nikolaos G Baikoussis, Panagiotis Dedeilias, Michalis Argiriou, Christos Charitos
A hybrid strategy, firstly performed in the 1990s, is a combination of tools available only in the catheterization laboratory with those available only in the operating room in order to minimize surgical morbidity and face with any cardiovascular lesion. The continuous evolution of stent technology along with the adoption of minimally invasive surgical approaches, make hybrid approaches an attractive alternative to standard surgical or transcatheter techniques for any given set of cardiovascular lesions. Examples include hybrid coronary revascularization, when an open surgical anastomosis of the left internal mammary artery to the left anterior descending coronary artery is performed along with stent implantation in non-left anterior descending coronary vessels, open heart valve surgery combined with percutaneous coronary interventions to coronary lesions, hybrid aortic arch debranching combined with endovascular grafting for thoracic aortic aneurysms, hybrid endocardial and epicardial atrial fibrillation procedures, and carotid artery stenting along with coronary artery bypass grafting...
January 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/27677872/successful-coronary-surgical-stenting-a-new-hybrid-approach
#18
Javier G Poveda, Gustavo L Silva, Pedro C Silva, Ângelo Nobre
Our goal is to introduce a new hybrid coronary revascularization concept-coronary surgical stenting. The procedure was performed on a 78-year old woman with severe, long and calcified involvement of the proximal left anterior descending artery, chronic total occlusion of the mid-left anterior descending artery and severe disease in the distal left anterior descending artery. An off-pump minimally invasive procedure was performed through the fifth intercostal space, including concurrent surgical placement of a drug-eluting stent in the distal left anterior descending artery, through the left anterior descending artery graft incision, associated with the left internal mammary artery to the mid-left anterior descending artery graft...
September 27, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27671454/outcomes-of-left-subclavian-artery-transposition-for-hybrid-aortic-arch-debranching
#19
Ludovic Canaud, Vincent Ziza, Baris Ata Ozdemir, Jean-Philippe Berthet, Charles-Henri Marty-Ané, Pierre Alric
BACKGROUND: The aim of this study was to evaluate outcomes of left subclavian artery (LSA) revascularization for hybrid aortic arch debranching. METHODS: Between 1998 and 2015, 68 patients (41 men, mean age 67+/-16 years) underwent TEVAR with LSA coverage, 19.2% (n = 13) were never revascularized and the remaining patients underwent LSA revascularization (n = 55; 80.8%) . Revascularization was achieved by LSA-carotid transposition via a medial approach in 81.8% (n = 45) and a lateral approach in 18...
September 23, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27666797/juxtarenal-inflammatory-aneurysm-treated-with-bilateral-iliac-renal-bypass-using-the-gore-hybrid-device-and-total-sealing-of-the-aneurysmal-sac-with-a-nellix-device
#20
Ombretta Martinelli, Alban Malaj, Roberto Gattuso, Luigi Irace, Bruno Gossetti
The aim of this study is to present the treatment of a juxtarenal inflammatory aneurysm using a Nellix device (Endologix, Inc., Irvine, CA) to seal the entire aneurysmatic aorta combined with bilateral iliac-renal bypass using the Gore hybrid vascular graft (W. L. Gore & Associates, Inc., Flagstaff, AZ). A 63-year-old man was diagnosed with a 6-cm juxtarenal inflammatory aneurysm. It was initially decided to treat him with an aorto-aortic bypass and to revascularize the 2 renal arteries with "graft to renal artery bypass" using Gore hybrid vascular grafts...
January 2017: Annals of Vascular Surgery
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