HE Xiaoyi , ZHANG Huajun , CHENG Nan , YANG Ming , GUO Yi , KANG Wenbin , WANG Rong
  • Department of Cardiovascular Surgery of The General Hospital of People’s Liberation Army, Beijing, 100853, P.R.China;
WANG Rong, Email: wangrongd@126.com
Coronary artery disease; aged patients; minimally invasive surgery; da Vinci surgical system; coronary artery bypass grafting; percutaneous coronary intervention
10.7507/1007-4848.202101050
Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables References Cited by

Objective To compare the perioperative results of hybrid coronary revascularization (HCR), off-pump coronary artery bypass (OPCAB) and percutaneous coronary intervention (PCI) in elderly patients with three-vessel coronary artery disease involving left anterior descending (LAD) branch and explores the safety of surgery.Methods We prospectively enrolled patients with coronary heart disease over 65 years who were admitted to General Hospital of People’s Liberation Army from January 2018 to September 2019. Coronary angiography results were all three-vessel lesions involving the anterior descending artery. After preoperative examination and assessment by the cardiovascular team, all patients were suitable for OPCAB or PCI treatment. According to the patient’s preference, HCR, OPCAB or PCI were performed. The preoperative baseline data and perioperative results were collected, and SPSS 22.0 was used for statistical analysis.Results A total of 110 patients met the criteria and were included in the study, 28 in the HCR group, 45 in the OPCAB group, and 37 in the PCI group, with an average age of 71.4±5.6 years. There was no statistical difference in the preoperative baseline data of patients among the three groups. The intubation time (P=0.039), perioperative drainage volume (P<0.001), blood transfusion (P=0.021) in the HCR group were lower than those in the OPCAB group. There was no statistical difference in the main organ adverse events (MOAE, P=0.096) and in-hospital mortality (P=0.784) among the three groups of patients. The use of antibiotics in the PCI group was significantly lower than the other two groups (P<0.001).Conclusion HCR combines the advantage of CABG and PCI including proved long-term patency rate with left internal mammary artery-LAD grafting, less trauma and superior long-term patency with PCI in non-LAD territory. Compared with OPCAB and PCI, there is no increase in perioperative major organ adverse events and in-hospital mortality. It is a safe and reliable minimally invasive myocardial revascularization technique for elderly patients with three-vessel coronary artery disease involving the anterior descending artery.

Citation： HE Xiaoyi, ZHANG Huajun, CHENG Nan, YANG Ming, GUO Yi, KANG Wenbin, WANG Rong. Comparative study on the perioperative results of different myocardial revascularization strategy in the treatment of elderly patients with coronary three-vessel disease. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(6): 627-632. doi: 10.7507/1007-4848.202101050 Copy

  • Previous Article

    Minimally invasive coronary artery bypass grafting: Current thoughts and prospects

  • Next Article

    Intermittent two-lung ventilation during minimally invasive coronary artery bypass grafting on the application of triangular-sail technique