"Hybrid" revascularization: video-thoracoscopy assisted MIDCAB combined with angioplasty

A "hybrid" revascularization technique has been developed for cases in which a chronic total occlusion of the left anterior descending coronary artery (LAD) cannot be recanalized by percutaneous coronary intervention, but the lesions in the right coronary artery and/or left circumflex artery are very good candidates for angioplasty. This technique, which uses video-thoracoscopy assisted minimally invasive direct coronary artery bypass to recanalize the occluded LAD and angioplasty to dilate favorable lesions in other vessels, would achieve complete revascularization in selected patients with multi-vessel disease. In this preliminary study of four patients, angioplasty and stenting were successful in all patients without any complications; complete revascularization was achieved in all 4 patients. No recurrence of angina and no cardiovascular events developed during follow-up; this study therefore supports the belief that the "hybrid" revascularization technique is both feasible and safe.