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Hybrid Revascularization Approach in a Patient With Cancer Metastatic to the Sternum
Shengyi Fu1, Mohammed Elzeneini1, Richard A Kerensky1
1Department of Cardiovascular Medicine, University of Florida College of Medicine, Gainesville, Florida, USA.
Insights
Hybrid revascularization offers a less invasive option for multivessel coronary artery disease. This approach proved safe and effective for a high-risk patient, demonstrating its potential in complex cases.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
Background:
- Hybrid revascularization presents a minimally invasive alternative to traditional coronary artery bypass grafting for multivessel coronary artery disease.
- Despite its benefits, adoption is limited by technical complexity, logistical hurdles, and concerns regarding long-term graft patency.
Observation:
- A 68-year-old male patient with a history of prostate cancer and bone metastasis presented with accelerated angina.
- Diagnostic left heart catheterization confirmed multivessel coronary disease.
- The patient underwent a staged hybrid surgical and percutaneous revascularization procedure.
Findings:
- The hybrid intervention was technically successful.
- The patient experienced significant symptomatic relief post-procedure.
- Successful recovery to baseline functional status was achieved.
Implications:
- This case highlights the efficacy of a tailored hybrid approach for high-risk patients with comorbidities.
- Hybrid revascularization can be safely considered for complex cases on an individualized basis.
Background:
Hybrid revascularization is a less invasive approach to conventional open-chest coronary artery bypass graft surgery for patients with multivessel coronary arterial disease. However, this is infrequently performed because of technical demands, logistical challenges, and concerns for long-term vessel patency.
Case Summary:
A 68-year-old man with a history of prostate cancer with bony metastasis presented with accelerated angina. Left heart catheterization revealed multivessel coronary disease. The patient underwent staged hybrid surgical and percutaneous revascularization treatment. Ultimately, the intervention was successful, and the patient had symptomatic relief with successful recovery to baseline function.
Discussion:
This case provides insight into the efficacy and application of an individualized hybrid approach in a high-risk patient with comorbidities.
Take-Home Message:
Hybrid revascularization is safe and can be considered on an individual basis for patients with complex medical comorbidities.
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