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Hybrid approach in patients with aortic valve disease and concomitant coronary heart disease: retrospective study

Kostiantyn Boyko1, Borys Todurov1, Andrii Khokhlov2

  • 1HEART INSTITUTE MINISTRY OF HEALTH OF UKRAINE, KYIV, UKRAINE; SHUPYK NATIONAL HEALTHCARE UNIVERSITY OF UKRAINE, KYIV, UKRAINE.

Polski Merkuriusz Lekarski : Organ Polskiego Towarzystwa Lekarskiego
|February 14, 2025
PubMed

Insights

The hybrid approach combining aortic valve replacement (AVR) with percutaneous coronary intervention (PCI) shows similar complication rates to traditional surgery. Patients experienced a better pain index six months post-procedure.

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Cardiac Rehabilitation

Background:

  • Coronary heart disease (CHD) and aortic valve disease often coexist, necessitating complex treatment strategies.
  • Traditional treatment involves separate or staged interventions, potentially increasing patient burden and recovery time.

Purpose of the Study:

  • To evaluate the effectiveness of a hybrid approach combining aortic valve replacement (AVR) with percutaneous coronary intervention (PCI).
  • To compare outcomes of the hybrid AVR + PCI approach versus AVR + coronary artery bypass grafting (CABG) in patients with CHD and aortic valve disease.

Main Methods:

  • Retrospective analysis of 130 adult patients undergoing AVR with myocardial revascularization between 2018-2022.
  • Group 1: 51 patients (AVR + PCI); Group 2: 79 patients (AVR + CABG).
  • Quality of life assessed using the Short Form 36 Survey (SF-36) at 6 and 12 months post-procedure.

Main Results:

  • The AVR + PCI group demonstrated significantly shorter cardiopulmonary bypass and aorta cross-clamping times (1.5x and 1.4x lower, respectively) compared to the AVR + CABG group (p=0.0001).
  • At 6 months, patients in the AVR + PCI group reported a significantly better SF-36 pain index (13.5% higher, p=0.017).
  • No significant differences were observed in other SF-36 quality of life indicators between the groups.

Conclusions:

  • The hybrid approach (AVR + PCI) offers comparable postoperative complication rates to the conventional surgical approach (AVR + CABG).
  • Patients undergoing the hybrid intervention experienced improved pain scores at six months post-procedure.
  • This hybrid strategy represents a viable and potentially beneficial treatment option for select patients with combined CHD and aortic valve disease.
Abstract

Keywords:
aortic valve replacementcoronary artery bypass graftingmyocardial revascularizationpercutaneous coronary interventionsquality of life

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