Hybrid interventions

Summary

Hybrid treatment of cardiac patients consists in the intentional combination of techniques traditionally reserved to the catheterisation laboratory with techniques traditionally performed in the operating theatre. For multivessel coronary disease the combination of a minimally-invasive internal mammary graft and PCI with drug-eluting stents potentially offers the benefits of both treatments. A similar principle applies to mixed coronary and valvular disease with contemporary percutaneous and minimally-invasive techniques.

Key logistical features include access to a hybrid procedure room with the facilities of both a catheterisation laboratory and an operating theatre. Furthermore, communication and liason between cardiologists and surgeons must be excellent. This chapter focuses on various combinations of minimally invasive cardiac treatments, including percutaneous coronary intervention, valve implantation and endoscopic valve surgery. The goal of combining different techniques is to maximise patient’s comfort without compromising the outcome.

Definition and rationale

Hybrid approaches or strategies in cardiac patients can be defined as the intentional combination of techniques traditionally reserved for the catheterisation laboratory with techniques traditionally performed in the operating theatre. These hybrid approaches necessitate skills and competences classically displayed by both cardiovascular surgeons and interventional cardiologists. Each member of the “Heart Team” 1