Hybridization Surgery Saves Critical Coronary Heart Disease

Mr. Hu, 80 years old, has been bedridden for a long time and suffered from coronary heart disease for many years. Recently, coronary angiography showed that the opening of the left main stem was 95% stenotic, the proximal section of the anterior descending branch was 60% stenotic, and the opening of the diagonal branch was 80% stenotic, which can be said to be a life-threatening situation. As the arteries supplying blood to the heart, coronary arteries are divided into left and right branches, and there are abundant anastomotic branches or side branches between the left and right branches. The left main stem, anterior descending branch and diagonal branch are all important blood vessels. However, Mr. Hu was too old and weak to undergo open-heart surgery, and the risk of cardiac arrest with the medical treatment of interventional stenting was too great. The treatment plan was in a dilemma. Besides drugs, surgical bypass and medical interventional stenting are the two major life-saving options for coronary heart disease. The advantages and disadvantages of both are mutually exclusive. Surgery is often traumatic, while medical intervention for coronary artery disease is the most common form of revascularization nowadays, which is less traumatic and quicker for patients to recover, but less effective for left main stem lesions and severe lesions of major blood vessels, and especially for unprotected left main stem lesions with a high operative mortality rate, which is a forbidden area for medical intervention. The sky is the limit, if the medical and surgical departments join hands, maybe “the light will turn on”. A unanimous decision was made to save Mr. Hu through a “hybrid” technique. First, the cardiac surgery department performed a minimally invasive non-stop coronary artery bypass grafting through a small incision in the chest to establish blood flow to the anterior descending coronary arteries, creating a protected left main trunk and reducing the risk of medical intervention. The left trunk and diagonal branch stents were then placed through medical intervention to achieve complete revascularization, i.e., circulation was re-established. Mr. Hu recovered quickly. Coronary artery disease “hybrid” technology is particularly suitable for the elderly or renal insufficiency, respiratory insufficiency and other patients who can not tolerate open heart surgery, not only reduces the trauma of surgery, but also reduces the risk of medical intervention, so that patients who could not have been able to carry out the medical intervention becomes feasible. “Hybridization” surgery is a new breakthrough in the field of cardiac treatment, enabling the perfect combination of medicine and surgery, and bringing together multidisciplinary experts into a team to work together for the cure of the disease. Hybridization technology can be applied to many areas of cardiology, and Ruijin Hospital has successfully completed nearly 100 cases of hybrid cardiac surgery, including coronary heart disease, congenital heart disease and large-vessel aneurysms. The establishment of the “hybridization” model not only provides patients with safer and more reliable treatment options, reduces trauma and facilitates recovery, but also provides a platform for mutual exchange and learning for the development of various disciplines, which is important for the invention of new surgical techniques and the creation of more perfect surgical procedures.