Robotically Assisted Hybrid Coronary Intervention
| Autor: | Guy Friedrich, Tomislav Mihaljevic, Eric J. Lehr, Mark R. Vesely, Johannes Bonatti, Jeffrey D. Lee, Ravi Nair, David Zimrin |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Bypass grafting business.industry medicine.medical_treatment Percutaneous coronary intervention Clopidogrel medicine.disease Surgery Coronary artery disease surgical procedures operative medicine.anatomical_structure Intervention (counseling) Conventional PCI medicine Robotic surgery cardiovascular diseases business medicine.drug Artery |
| Zdroj: | Robotic Surgery ISBN: 9783030535933 |
| DOI: | 10.1007/978-3-030-53594-0_126 |
| Popis: | Hybrid coronary intervention (HCI) is a combination of minimally invasive coronary artery bypass grafting and percutaneous coronary intervention (PCI). In its classic version, a less invasively placed left internal mammary artery bypass to the left anterior descending (LAD) artery is combined with PCI to non-LAD targets. Advanced forms of hybrid interventions combine multiple coronary bypass grafts with PCI. Hybrid coronary intervention represents an appealing alternative to multivessel coronary artery bypass grafting through sternotomy. Robotic techniques add value as the surgical part can be performed in completely endoscopic fashion through ports only. The most common way of performing HCI is staged with the robotic minimally invasive surgical part going first followed by PCI a few days later. The main advantage of this approach is that robotic surgery is carried out without dual antiplatelet therapy (DAPT). A PCI first method is chosen if the PCI target causes acute symptoms or is regarded high risk. Robotic surgery is in this case performed under DAPT. With the installation of hybrid operating rooms, simultaneous versions of HCR have also become feasible. If performed as a simultaneous procedure, the patient is loaded with clopidogrel immediately after conduct of the robotic surgery. Therefore bleeding has to be meticulously checked during the surgical part. If performed staged, the care team has to be aware of possible interval ischemia. Therefore a short timeframe between the two procedure parts is advisable. |
| Databáze: | OpenAIRE |
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