The New Era of Cardiac Surgery Hybrid Therapy for Cardiovascular Disease

Author(s):  
Natalia V. Solenkova ◽  
Ramanan Umakanthan ◽  
Marzia Leacche ◽  
David X. Zhao ◽  
John G. Byrne

Surgical therapy for cardiovascular disease carries excellent long-term outcomes but it is relatively invasive. With the development of new devices and techniques, modern cardiovascular surgery is trending toward less invasive approaches, especially for patients at high risk for traditional open heart surgery. A hybrid strategy combines traditional surgical treatments performed in the operating room with treatments traditionally available only in the catheterization laboratory with the goal of offering patients the best available therapy for any set of cardiovascular diseases. Examples of hybrid procedures include hybrid coronary artery bypass grafting, hybrid valve surgery and percutaneous coronary intervention, hybrid endocardial and epicardial atrial fibrillation procedures, and hybrid coronary artery bypass grafting/carotid artery stenting. This multi-disciplinary approach requires strong collaboration between cardiac surgeons, vascular surgeons, and interventional cardiologists to obtain optimal patient outcomes.

2005 ◽  
Vol 7 (2) ◽  
pp. 88 ◽  
Author(s):  
James R. Edgerton ◽  
Morley A. Herbert ◽  
Katherine K. Jones ◽  
Syma L. Prince ◽  
Tea Acuff ◽  
...  

Author(s):  
Francis P Sutter ◽  
Tami Berry ◽  
MaryAnn C Wertan

Coronary artery bypass grafting remains the treatment choice for coronary artery disease; but sternotomy, the most commonly used approach, compromises its benefits with postoperative morbidity, higher complication rates, and prolonged length of hospital stay. Despite this, minimally invasive and robotic-assisted technology has not been adopted or widely embraced because supporting literature on robotic-assisted coronary artery bypass grafting is extremely limited. Since 2005, the cardiothoracic surgical team at our institution has been developing and maturing an effective method using robotic harvesting of the left internal mammary artery (LIMA) and beating heart surgery through a minithoracotomy for coronary revascularization. This surgical technique involves precisely placing the robotic endoscopic port immediately over the left anterior descending (LAD) artery target site. The robotically harvested LIMA is secured to the epicardium at the LAD target, the robotic instruments are removed, and the endoscopic port site is enlarged slightly greater than 1 cm to become the minithoracotomy and allow for LIMA-to-LAD anastomosis. The other two robotic ports are used to complete the procedure without a need for additional incisions. This standardized method has been used in more than 750 patients, and since 2009, the last 377 consecutive non-rib-spreading minithoracotomy incisions measured a median of 3.9 cm (mean [SD], 4.16 [1.2748] cm; range, 2.3–12.0 cm). This “How I Do It” article describes our methods in detail and associated robotic nuances.


1996 ◽  
Vol 60 (3) ◽  
pp. 177-180 ◽  
Author(s):  
Takaki Sugimoto ◽  
Kyoichi Ogawa ◽  
Tatsuro Asada ◽  
Nobuhiko Mukohara ◽  
Tetsuya Higami ◽  
...  

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