Combination of minimally invasive coronary bypass and percutaneous transluminal coronary angioplasty in the treatment of double-vessel coronary disease: Two-year follow-up of a new hybrid procedure compared with "on-pump" double bypass grafting

D. De Cannière, J. L. Jansens, Pascal Goldschmidt-Clermont, L. Barvais, P. Decroly, E. Stoupel

Research output: Contribution to journalArticle

70 Citations (Scopus)

Abstract

Objective: Percutaneous transluminal coronary angioplasty (PTCA) or surgery can be chosen as first-line therapies in multiple-vessel coronary disease. A mammary-to-left anterior descending (LAD) graft is the most important statistical determinant of a favorable outcome after coronary artery bypass grafting (CABG) and can be performed with lower morbidity off pump through a minithoracotomy. PTCA and stenting of the "non-LAD" vessels compete with CABG in terms of patency rates. Our purpose was to compare a combination of minimally invasive direct coronary artery bypass (MIDCAB) and PTCA with double CABG as a treatment for double-vessel coronary artery disease involving the proximal LAD. Methods: Two matched groups of 20 patients with double-vessel coronary disease undergoing either sequential MIDCAB and PTCA (group 1) or double CABG on cardiopulmonary bypass (group 2) were compared. Angiographic control, complications, hospital costs, quality of life, and 2-year follow-up of ischemia are reported. Results: All bypasses were patent at early control. Three adverse events were noted in group 1 and 17 in group 2. The hybrid-procedure group exhibited a shorter intensive care unit stay, fewer blood products transfused, less pain, better early quality of life, faster return to work, and similar cost. Three patients required a second PTCA in group 1, one of which for restenosis. At 2 years all the patients are asymptomatic with no residual ischemia. Conclusions: We conclude from this pilot study that the hybrid procedure is feasible and appears to be a safe therapy for double-vessel coronary artery disease and that it appears to generate less perioperative morbidity than classic double CABG does. Therefore we believe that there is room to undertake prospective randomized studies on a larger-scale basis.

Original languageEnglish
Pages (from-to)563-570
Number of pages8
JournalAmerican Heart Journal
Volume142
Issue number4
DOIs
StatePublished - Oct 8 2001
Externally publishedYes

Fingerprint

Coronary Balloon Angioplasty
Coronary Artery Bypass
Coronary Disease
Therapeutics
Coronary Artery Disease
Ischemia
Quality of Life
Morbidity
Return to Work
Hospital Costs
Cardiopulmonary Bypass
Intensive Care Units
Breast
Research Design
Prospective Studies
Transplants
Costs and Cost Analysis
Pain

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Combination of minimally invasive coronary bypass and percutaneous transluminal coronary angioplasty in the treatment of double-vessel coronary disease : Two-year follow-up of a new hybrid procedure compared with "on-pump" double bypass grafting. / De Cannière, D.; Jansens, J. L.; Goldschmidt-Clermont, Pascal; Barvais, L.; Decroly, P.; Stoupel, E.

In: American Heart Journal, Vol. 142, No. 4, 08.10.2001, p. 563-570.

Research output: Contribution to journalArticle

@article{2d66543fb221410289dd74debf20ac85,
title = "Combination of minimally invasive coronary bypass and percutaneous transluminal coronary angioplasty in the treatment of double-vessel coronary disease: Two-year follow-up of a new hybrid procedure compared with {"}on-pump{"} double bypass grafting",
abstract = "Objective: Percutaneous transluminal coronary angioplasty (PTCA) or surgery can be chosen as first-line therapies in multiple-vessel coronary disease. A mammary-to-left anterior descending (LAD) graft is the most important statistical determinant of a favorable outcome after coronary artery bypass grafting (CABG) and can be performed with lower morbidity off pump through a minithoracotomy. PTCA and stenting of the {"}non-LAD{"} vessels compete with CABG in terms of patency rates. Our purpose was to compare a combination of minimally invasive direct coronary artery bypass (MIDCAB) and PTCA with double CABG as a treatment for double-vessel coronary artery disease involving the proximal LAD. Methods: Two matched groups of 20 patients with double-vessel coronary disease undergoing either sequential MIDCAB and PTCA (group 1) or double CABG on cardiopulmonary bypass (group 2) were compared. Angiographic control, complications, hospital costs, quality of life, and 2-year follow-up of ischemia are reported. Results: All bypasses were patent at early control. Three adverse events were noted in group 1 and 17 in group 2. The hybrid-procedure group exhibited a shorter intensive care unit stay, fewer blood products transfused, less pain, better early quality of life, faster return to work, and similar cost. Three patients required a second PTCA in group 1, one of which for restenosis. At 2 years all the patients are asymptomatic with no residual ischemia. Conclusions: We conclude from this pilot study that the hybrid procedure is feasible and appears to be a safe therapy for double-vessel coronary artery disease and that it appears to generate less perioperative morbidity than classic double CABG does. Therefore we believe that there is room to undertake prospective randomized studies on a larger-scale basis.",
author = "{De Canni{\`e}re}, D. and Jansens, {J. L.} and Pascal Goldschmidt-Clermont and L. Barvais and P. Decroly and E. Stoupel",
year = "2001",
month = "10",
day = "8",
doi = "10.1067/mhj.2001.118466",
language = "English",
volume = "142",
pages = "563--570",
journal = "American Heart Journal",
issn = "0002-8703",
publisher = "Mosby Inc.",
number = "4",

}

TY - JOUR

T1 - Combination of minimally invasive coronary bypass and percutaneous transluminal coronary angioplasty in the treatment of double-vessel coronary disease

T2 - Two-year follow-up of a new hybrid procedure compared with "on-pump" double bypass grafting

AU - De Cannière, D.

AU - Jansens, J. L.

AU - Goldschmidt-Clermont, Pascal

AU - Barvais, L.

AU - Decroly, P.

AU - Stoupel, E.

PY - 2001/10/8

Y1 - 2001/10/8

N2 - Objective: Percutaneous transluminal coronary angioplasty (PTCA) or surgery can be chosen as first-line therapies in multiple-vessel coronary disease. A mammary-to-left anterior descending (LAD) graft is the most important statistical determinant of a favorable outcome after coronary artery bypass grafting (CABG) and can be performed with lower morbidity off pump through a minithoracotomy. PTCA and stenting of the "non-LAD" vessels compete with CABG in terms of patency rates. Our purpose was to compare a combination of minimally invasive direct coronary artery bypass (MIDCAB) and PTCA with double CABG as a treatment for double-vessel coronary artery disease involving the proximal LAD. Methods: Two matched groups of 20 patients with double-vessel coronary disease undergoing either sequential MIDCAB and PTCA (group 1) or double CABG on cardiopulmonary bypass (group 2) were compared. Angiographic control, complications, hospital costs, quality of life, and 2-year follow-up of ischemia are reported. Results: All bypasses were patent at early control. Three adverse events were noted in group 1 and 17 in group 2. The hybrid-procedure group exhibited a shorter intensive care unit stay, fewer blood products transfused, less pain, better early quality of life, faster return to work, and similar cost. Three patients required a second PTCA in group 1, one of which for restenosis. At 2 years all the patients are asymptomatic with no residual ischemia. Conclusions: We conclude from this pilot study that the hybrid procedure is feasible and appears to be a safe therapy for double-vessel coronary artery disease and that it appears to generate less perioperative morbidity than classic double CABG does. Therefore we believe that there is room to undertake prospective randomized studies on a larger-scale basis.

AB - Objective: Percutaneous transluminal coronary angioplasty (PTCA) or surgery can be chosen as first-line therapies in multiple-vessel coronary disease. A mammary-to-left anterior descending (LAD) graft is the most important statistical determinant of a favorable outcome after coronary artery bypass grafting (CABG) and can be performed with lower morbidity off pump through a minithoracotomy. PTCA and stenting of the "non-LAD" vessels compete with CABG in terms of patency rates. Our purpose was to compare a combination of minimally invasive direct coronary artery bypass (MIDCAB) and PTCA with double CABG as a treatment for double-vessel coronary artery disease involving the proximal LAD. Methods: Two matched groups of 20 patients with double-vessel coronary disease undergoing either sequential MIDCAB and PTCA (group 1) or double CABG on cardiopulmonary bypass (group 2) were compared. Angiographic control, complications, hospital costs, quality of life, and 2-year follow-up of ischemia are reported. Results: All bypasses were patent at early control. Three adverse events were noted in group 1 and 17 in group 2. The hybrid-procedure group exhibited a shorter intensive care unit stay, fewer blood products transfused, less pain, better early quality of life, faster return to work, and similar cost. Three patients required a second PTCA in group 1, one of which for restenosis. At 2 years all the patients are asymptomatic with no residual ischemia. Conclusions: We conclude from this pilot study that the hybrid procedure is feasible and appears to be a safe therapy for double-vessel coronary artery disease and that it appears to generate less perioperative morbidity than classic double CABG does. Therefore we believe that there is room to undertake prospective randomized studies on a larger-scale basis.

UR - http://www.scopus.com/inward/record.url?scp=0034813365&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034813365&partnerID=8YFLogxK

U2 - 10.1067/mhj.2001.118466

DO - 10.1067/mhj.2001.118466

M3 - Article

C2 - 11579343

AN - SCOPUS:0034813365

VL - 142

SP - 563

EP - 570

JO - American Heart Journal

JF - American Heart Journal

SN - 0002-8703

IS - 4

ER -