Electrocoagulation-free strategy in minimally invasive direct coronary artery bypass with hybrid revascularisation - a case report.

BACKGROUND: Hybrid coronary revascularisation benefits patients with multivessel disease, as it amalgamates the minimally invasive direct coronary artery bypass (MIDCAB) procedure and percutaneous coronary intervention (PCI). We present a 63-year-old female with triple-vessel coronary artery disease including marked ostial stenosis of the left main coronary artery, as well as moderate stenosis of the right coronary artery. The risk of death following heart surgery (EuroSCORE II) is 4.27%. The patient exhibited multiple morbidities including chronic obstructive pulmonary disease, renal impairment, extracardiac arteriopathy, and multiple prior gastrointestinal surgeries, as well as a recent episode of paroxysmal atrial fibrillation. A MIDCAB procedure without electrocoagulation was stipulated by the ENT specialist due to the patient's cochlear implant.

CONCLUSION: A successful MIDCAB procedure omitting electrocoagulation was performed for the first time for multivessel coronary disease in a multimorbid patient as part of a hybrid approach.