Minimally Invasive Hybrid Revascularisation is a procedure that combines minimally invasive coronary artery bypass grafting surgery (CABG) and angiography stenting procedure to restore blood flow to the heart when there is a build-up of plaque in the blood vessels. Patients with triple vessel blockage are mostly treated with a conventional Bypass surgery (by splitting the central chest bone) which is an intense procedure that needs a longer recovery time post-surgery.
This procedure allows the surgeon to work on a beating heart through a small chest incision (small thoracotomy) between the ribs with the help of high definition camera and monitor (Thoracoscope), without having to split the breastbone. This procedure helps quick recovery and major morbidity.
This Minimally Invasive Hybrid Revascularisation procedure has a unique two stage approach. Blockage of blood flow in the main vessel requires surgery while blocks in the other blood vessels supplying blood to the heart, can be treated either with surgery or angiography stent insertion. An Endoscopic Minimally Invasive CABG to the main vessel can be done followed by Angiography and stent insertion to the other vessels.
During the Endoscopic Minimally Invasive CABG, the surgeons perform the operation through a tiny incision under the left nipple (four or five centimeters wide) while the heart continues to beat. This technique lowers the risk of complications such as stroke, lung problems and kidney problems which are associated with the use of a heart-and-lung machine (in a conventional bypass procedure). The patients have reduced pain and less need for postoperative pain medication, smaller scars, a shorter stay in the hospital and a faster recovery. As a stage two approach, angiography and drug eluting stent insertion to the remaining 2 blockages in the coronary artery under specialised Intravascular ultrasound guidance will be performed.
Hybrid revascularisation has alleviated all complications and the patient can be discharged on the fourth day post the procedure without any blood transfusion. This procedure is suitable to treat most patients with triple vessel coronary artery disease. Patients tend to have less pain with negligible risk and are able to return to normal activity within two weeks.
India’s first minimally invasive Hybrid Revascularization procedure was performed at Apollo Hospitals, Chennai by Dr. MM Yusuf. The surgery was performed to treat a triple vessel coronary artery block and give a new lease of life to a 57-year-old male patient, Mr. Zahir Hussain.
UPDATED ON 15/11/2023