Hybrid revascularisation is an innovative approach where Dr Bassin will work with an interventional cardiologist to tailor a hybrid treatment for you, which combines less invasive surgical techniques with procedures performed by a cardiologist in the cardiac catheter lab. This collaborative solution means less surgical trauma while still ensuring the best possible outcome for the patient.
What is Hybrid
Hybrid cardiac surgery combines traditional heart surgery and interventional cardiology to facilitate less invasive surgery. These techniques can be used for coronary bypass, mitral valve or aortic valve surgery.
Cardiac or heart surgery is performed by qualified cardiothoracic surgeons in an operating theatre under general anaesthetic. Typical operations include coronary artery bypass grafting (CABG), heart valve repair or replacement and replacement of a diseased aorta.
Coronary stenting is an alternative for narrowed or blocked coronary arteries and is performed by an interventional cardiologist in a cardiac catheter lab, usually without general anaesthesia. A coronary stent is a small scaffold that sits within a narrowed segment of a coronary artery to keep it open. The stent is placed via a small catheter in the wrist (radial artery) or the leg artery (femoral artery). Recovery is rapid and patients can usually go home the same day.
Hybrid cardiac surgery is when a cardiothoracic surgeon will perform minimally invasive heart surgery and then a cardiologist will open one or two coronary blockages with a stent. This means that patients who have coronary and valve disease can still undergo minimally invasive or robotic heart surgery.
What is involved?
Hybrid cardiac surgery involves a combination of minimally invasive or robotic heart surgery and the placement of coronary stents in a separate procedure. The timing of the two procedures depends on a number of factors including how severe the coronary blockages are and how urgent the heart surgery is.
Typically, a patient will undergo minimally invasive heart surgery and then a few days later will have the stents placed by an interventional cardiologist. Coronary stents require blood thinners including aspirin and clopidogrel which can increase the chance of bleeding during surgery; therefore, it is important to ensure all bleeding has been resolved after the surgery. If a patient has a severely narrowed coronary artery we may place a stent prior to minimally invasive heart surgery. The surgery will then be delayed by 6 weeks or more and the blood thinners reduced just prior to the heart surgery.
The timing and planning of each hybrid procedure is very individualised and Dr Bassin will plan this in conjunction with your cardiologist. The hospital stay is not prolonged for hybrid surgery and the recovery and trauma is reduced compared to traditional open heart surgery.
What is the recovery like?
The recovery after hybrid surgery is far more rapid than traditional open heart surgery. You will recover in hospital for a few days after your surgery until you regain your strength to have the stents placed. Most patients can go home after 6-7 days.
Once at home, patients who have undergone hybrid surgery continue recovery a lot faster than those who have undergone open heart surgery with splitting of the breastbone. Mobilisation is far easier and there aren’t any restrictions on lifting. Patients are encouraged to take plenty of walks. Your body will let you know what it’s capable of and there is no need to push it. Most patients will feel back to their usual selves after about 4 weeks following a hybrid procedure compared with 3 months following traditional open heart surgery.
What are the benefits and risks of this procedure?
The risks of hybrid surgery include the same risks of minimally invasive heart surgery as well as the risks of coronary stenting. This is offset by the reduced risks of bleeding, infection and trauma that occurs with open heart surgery.
Dr Bassin will explain these risks to each patient in person and how they pertain to their specific condition.