One-stop hybrid technique to treat coronary atherosclerotic disease concomitant with penetrating atherosclerotic ulcers in 23 patients

Abstract

Objective Retrospectively reviewed the early outcomes of one-stop hybrid technique to treat coronary atherosclerotic disease concomitant with penetrating atherosclerotic ulcers (PAU). Methods This study enrolled in 23 cases (male 21, female 2) of coronary atherosclerotic disease concomitant with penetrating atherosclerotic ulcers from Jan 2016 to Dec 2017 in our institute, with the mean age(67.5±7.5) years (51-79 years). Coronary artery bypass graft (CABG) surgery was performed by cardiopulmonary bypass (CPB), the procedure to treat aortic arch lesion included isolated CABG + thoracic endovascular stent graft in 2 patients, CABG + brachiocephalic arteries debranching + thoracic endovascular stent graft in 18 patients, CABG + hybrid total aortic arch replacement + thoracic endovascular stent graft in 3 patients. Results Mean CPB time was(94.3±25.7) min(55-145 min), mean aortic cross-clamp time was (61.4±19.3) min(26-97 min), intraoperative blood loss was(654.8±78.7)ml(510-900 ml), 20 patients(87.0%)needed blood transfusion therapy. Median mechanical ventilation time was 18 hours(9-249 hours), with 1 patient(4.3%)exceeded 48 hours. Median intensive care unit stay time was 2.8 days(1-23 days), with 6 patients(26.1%)exceeded 4 days. There was no in-hospital mortality. The postoperative complications included: paresis in 2 patients (8.7%), re-exploration for bleeding in 1 patient (4.3%), pleural effusion in 1 patient (4.3%), pneumothorax in 1 patient (4.3%), paraplegia、pulmonary infection、acute renal insufficiency、respiratory failure、re-intubation in 1 patient (4.3%). Conclusion The one-stop hybrid technique for treating coronary atherosclerotic disease concomitant with PAU was effective and safe. The early clinical outcome was satisfactory. Mid and long-term result need further follow-up to study. Key words: Coronary artery bypass graft; Cardiac surgical procedures; Stent; Hybrid technique