Yamashita Yoshiyuki, Sicouri Serge, Rodriguez Roberto, Gray William A, Sutter Francis P, Ramlawi Basel
Department of Cardiothoracic Surgery Research, Lankenau Institute for Medical Research, Wynnewood, PA, USA.
Department of Cardiothoracic Surgery, Lankenau Heart Institute, Wynnewood, PA, USA.
J Cardiol Cases. 2024 Mar 22;30(1):12-15. doi: 10.1016/j.jccase.2024.03.001. eCollection 2024 Jul.
We report a hybrid procedure of robotic-assisted coronary artery bypass grafting and transcatheter aortic valve-in-valve implantation for left main disease and prosthetic aortic valve stenosis. Robotic-assisted coronary artery bypass grafting using a left internal mammary artery graft was preferred to percutaneous coronary intervention because of the complex anatomy of the coronary lesion and concerns about dual antiplatelet therapy tolerance. This was followed by a valve-in-valve procedure five days later, allowing the patient to be discharged the next day. This innovative, less invasive approach demonstrates the feasibility and potential for early recovery in appropriately selected patients with complex coronary and aortic valve disease.
Hybrid robotic-assisted coronary artery bypass grafting (CABG) and transcatheter aortic valve replacement (AVR) is a feasible and less invasive approach for appropriately selected patients with complex coronary and aortic valve disease who are not good candidates for percutaneous coronary intervention or conventional CABG and surgical AVR.
我们报告了一例机器人辅助冠状动脉旁路移植术与经导管主动脉瓣中瓣植入术相结合的手术，用于治疗左主干病变和人工主动脉瓣狭窄。由于冠状动脉病变解剖结构复杂以及对双联抗血小板治疗耐受性的担忧，使用左乳内动脉移植物进行机器人辅助冠状动脉旁路移植术优于经皮冠状动脉介入治疗。五天后进行了瓣中瓣手术，患者于次日出院。这种创新的、侵入性较小的方法证明了在适当选择的复杂冠状动脉和主动脉瓣疾病患者中早期恢复的可行性和潜力。
机器人辅助冠状动脉旁路移植术（CABG）与经导管主动脉瓣置换术（AVR）相结合，对于那些不适合经皮冠状动脉介入治疗或传统CABG以及外科AVR的、适当选择的复杂冠状动脉和主动脉瓣疾病患者来说，是一种可行且侵入性较小的方法。
