The Washington Post reports that clinicians at the University of Maryland Medical Center (UMMC) in Baltimore are now performing combined coronary artery bypass surgery and angioplasty, through a minimally invasive approach. Special operating room modifications have allowed different clinical teams to perform two separate procedures at the same time:
The simultaneous hybrid procedure was first reported in 1996 in Germany, but it never became popular and only a few small studies were published about it thereafter.
During the hybrid procedure, the cardiac surgeon opens a 2 1/2 -inch incision under the patient’s left breast and bypasses the clogged main artery of the heart, called the left anterior descending artery (LAD), by using a blood vessel taken from elsewhere in the body.
Then the interventional cardiologist steps in to treat the smaller clogged arteries. Using a catheter that is threaded into the blockages, the physician implants stents — metal scaffolding — to keep the blood vessels open.
Sixty-three-year old Pearl Walker of Waynesboro, Pa., was having a heart attack when she arrived at UMMC in January. Her LAD was not fixable with a stent, and she had other arteries with blockages. “They said I was a prime candidate for [the hybrid procedure], and I wasn’t going to hesitate,” she said.
Her operation took about five hours, while the surgeon bypassed her LAD and the cardiologist snaked in three stents. She left the hospital two days later. “I’m good now,” she said, adding that she can go for walks with her husband and does step exercise with television fitness programs.
Most patients who qualify for the procedure have a blockage in the LAD that requires bypass, Poston said, and other arteries with blockages that angioplasty can open efficiently.
More at WaPo…