Objective: To assess whether a hybrid approach to the treatment of coronary artery disease with proximal left subclavian artery stenosis is superior to a staged approach.
Methods: We retrospectively analyzed 20 patients who underwent percutaneous transluminal angioplasty (PTA) and stenting treatment combined with coronary artery bypass grafting on the same day (hybrid group) between January 2013 and October 2015, and compared them with 23 patients who underwent PTA and stenting followed by coronary artery bypass graft 4 weeks later (staged group) between January 2008 and December 2012. Demographic data, preoperative risk factors, intraoperative measures, and postoperative outcomes were analyzed.
Results: The demographic data and preoperative risk factors were similar in the 2 groups. The total hospital length of stay was similar in the 2 groups, with a median of 9 days (range, 6-12 days) in the hybrid group versus 9 days (range, 8-15 days) in the staged group (P = .299). There were no postoperative complications (eg, myocardial infarction, stroke, renal failure) in either group. In both groups, the mortality rate was 0 in the hospital, at 1 month, and at 3 months. All patients in both groups had no symptom recurrence at follow-up. Angiography showed no significant difference in postoperative stenosis between the 2 groups at 3 months (P = .762).
Conclusions: The hybrid procedure of PTA and stenting followed by coronary artery bypass grafting may be an effective approach for patients with concomitant proximal left subclavian artery stenosis and coronary artery disease.
Keywords: coronary artery bypass grafting; coronary-subclavian steal syndrome; left subclavian artery stenosis; percutaneous intervention.
Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.