Department of Cardiology, Heart Centre Rostock, University of Rostock, Rostock, Germany.
Department of Cardiac Surgery, Heart Centre Rostock, University of Rostock, Rostock, Germany.
J Card Surg. 2021 Nov;36(11):4419-4422. doi: 10.1111/jocs.15967. Epub 2021 Sep 7.
We present a 76-year-old poly-morbid male patient suffering from severe ischemic mitral valve regurgitation. A hybrid approach was suggested by the heart team to treat his multifaceted cardiac pathologies.
At first percutaneous mitral valve repair with the mitraclip device was performed to reduce surgical risk. This was then followed by minimally invasive direct coronary artery bypass (MIDCAB).
At day 20 Post mitraclip intervention the patient suffered gastrointestinal bleeding which needed argon plasma coagulation (APC)-therapy and multiple blood transfusions. Stage II of the hybrid procedure was executed on post-intervention day 34 by minimally invasive direct coronary artery bypass (MIDCAB) to left anterior descending artery (LAD). Seven days later the patient was discharged. Up to two years of follow-up, the patient is in stable condition, without recurrent cardiac symptoms.
Hybrid approach of percutaneous mitral valve repair followed by MIDCAB is an effective minimally invasive treatment for severe ischemic mitral valve regurgitation and coronary artery disease.
我们介绍一位 76 岁的多系统疾病老年男性患者，患有严重缺血性二尖瓣反流。心脏团队建议采用杂交手术方法来治疗其多方面的心脏病变。
首先进行经皮二尖瓣修复术，使用 MitraClip 装置减少手术风险。然后进行微创直接冠状动脉旁路移植术（MIDCAB）。
MitraClip 干预后第 20 天，患者发生胃肠道出血，需要氩等离子凝固（APC）治疗和多次输血。杂交手术的第 2 阶段在干预后第 34 天通过微创直接冠状动脉旁路移植术（MIDCAB）进行到左前降支（LAD）。7 天后，患者出院。在两年的随访中，患者情况稳定，无复发性心脏症状。
经皮二尖瓣修复术联合 MIDCAB 的杂交手术方法是治疗严重缺血性二尖瓣反流和冠状动脉疾病的有效微创治疗方法。
