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Surgical Revascularization

Hybrid revascularization

Our Approach

Coronary artery disease pose some particular treatment challenges. Our doctors at MK Heart Clinic might recommend CABG (Coronary Artery Bypass Graft surgery) instead of angioplasty with stenting in order to determine that they cannot perform the surgery in a minimally invasive way.

Hybrid coronary revascularization can resolve that predicament potentially by combining these two treatments, stenting some blockages and bypassing others to treat Coronary artery disease. By bringing together this newer and evolving technique with the best of the catheterization lab and the operating room, we can assure to protect your heart and avoid open surgery. 

What is Coronary Artery Disease (CAD)?

Coronary arteries are the blood vessels which are located directly on the top of the heart muscle and aid in the supply of oxygen-rich blood to the heart muscle to keep it pumping. When there is a blockage or narrowing of the coronary arteries it leads to Coronary artery disease and is usually caused by the build-up of fatty material called plaque. Coronary artery disease which is also called CAD or coronary heart disease, ischemic heart disease and heart disease requires a Hybrid coronary revascularization to get treated. 

There are many causes of Coronary artery disease depending on the age, environment and lifestyle changes but some of the common conditions like high cholesterol level, high blood pressure, diabetes, alcohol intake, tobacco usage, unhealthy eating habits, obesity, remaining physically inactive, not getting enough quality of sleep, etc require a patient to undergo a Hybrid coronary revascularization.

About Hybrid Coronary Revascularization

While some individuals with blocked arteries require to be treated under open surgery, Hybrid coronary revascularization offers a possibility of minimally invasive technique with advanced treatment options. 

The advanced therapy of cardiac revascularization is an added advantage or a boon for multi vessel disease patients or patients with severe Coronary artery disease (CAD) because this Hybrid coronary revascularization resolves the predicament by combining both the minimal access bypass surgery with arterial grafts or coronary artery bypass graft (CABG) along with percutaneous coronary intervention – stenting or coronary angioplasty with stents.

A hybrid approach in coronary artery revascularization may help the patient with several blockages where doctors cannot open just by performing angioplasty. Instead, the interventional cardiologist stents some blockages and the surgeon connects a bypass graft to the heart’s critical (LAD)left anterior descending artery while performing the Hybrid coronary revascularization. 

Conventional Bypass Surgery, Minimal Access Bypass Surgery Vs Hybrid Coronary Revascularization

To know the cutting-edge technology of Hybrid coronary revascularization, one should understand the difference between conventional bypass surgery and minimal access bypass surgery. 

As mentioned earlier, the reason for coronary vascularization is that Hybrid coronary vascularization is a two-stage approach which serves a lot of benefits for treating the patients with Coronary artery disease more effectively.

Conventional Bypass Surgery

Traditionally, in conventional bypass surgery, the surgeon treats the triple vessel disease patients by Midline Sternotomy (opening the entire chest wall) and performs bypass surgical procedure to all three blood vessels using both arterial and venous grafts (veins taken from the lower limb), or total arterial revascularization (all the grafts are arteries and no veins are used for grafting). 

Generally, arterial grafts have lesser chances of re-occlusion (repeated recurrent blockages inside the bypass vessel) than venous grafts. Also, the recovery time takes a longer duration post-operative surgery in this intense procedure compared to that of Hybrid coronary revascularization.

Minimal Access Bypass Surgery

In minimal access bypass surgery, there is no requirement of opening the entire chest wall but the surgeon makes an incision of about 4- 5cm just below the left nipple and arterial grafting is performed on the left sided blood vessels alone because right sided blood vessels are usually difficult to access. 

The main advantage in this surgical procedure of minimal access bypass surgery compared to conventional bypass surgery is that patients have lesser complications similar to the Hybrid coronary revascularization like minimal scar and tissue damage.

Hybrid Coronary Revascularization

Hybrid Coronary Revascularization is a two-step procedure which combines minimally invasive coronary artery bypass grafting surgery and angiography stenting procedure to restore blood flow to the heart when a plaque is built-up in the blood vessels. Both the Cardiologist and Cardiothoracic Surgeon are closely involved because Hybrid revascularization procedure is done in a single admission for Triple Vessel Disease patients. 

Here in this procedure, the surgeon works on the beating heart by making a small chest incision between the ribs without having to split the breastbone using a thoracoscope (a high-definition camera and monitor). This procedure of Hybrid coronary revascularization helps the patients to have a major morbidity and also aids in rapid recovery.

Recovery at Home

Recovery after Hybrid coronary revascularization takes about six to eight weeks for the incisions to heal. At first, some muscle or incision discomfort will be experienced in the chest during activity. Itching, numbness or tightness along the incision is also normal. 

Follow the below mentioned guidelines to ensure proper healing after the Hybrid coronary revascularization by

  • Keep your incisions clean and dry
  • Avoid lifting heavy weights to protect your incision
  • Ensure to have a healthy diet by limiting salty and fatty foods

You have to approach the doctor after the Hybrid coronary revascularization, if you face signs of infection like,

  • Increased drainage or/and oozing from the incision
  • Increased opening of the incision
  • Increased body temperature
  • Warmth along the incision line
  • Redness around the area of incision

Pros and Cons of Hybrid Coronary Revascularization

The procedure of Hybrid coronary revascularization serves various benefits in treating coronary heart disease. Besides that, there are certain additional advantages of Hybrid coronary revascularization that include

  • Higher flexibility
  • More durability
  • Less complications 
  • Minimal pain
  • Less scarring
  • Shorter hospital stays
  • Faster recovery

Also, every heart procedure like the Hybrid coronary revascularization carries the possibility of complications but the major complications are 

  • Stroke
  • Myocardial infarction
  • Acute kidney injury
  • Lung problems
  • Wound infection
  • Bleeding requiring reoperation or transfusion
  • Prolonged requirement of mechanical ventilation
  • Death

If you or your loved one is in need of cardiac revascularization, you can approach our expert Cardiologist Dr. Kathiresan at MK Heart Clinic as he is the lead surgeon who is specialised in the hybrid approach and has built years of experience to perform Hybrid coronary revascularization using state-of-the-art techniques to protect your heart, avoid open surgery, keep you active and healthy, and provide you with the best quality of life possible.

Read also Symptoms of Heart Attack.

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