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. 2023 Aug 26;12(17):5553.
doi: 10.3390/jcm12175553.

Combined Minimally Invasive Mitral Valve Surgery and Percutaneous Coronary Intervention: A Hybrid Concept for Patients with Mitral Valve and Coronary Pathologies

Martín Moscoso-Ludueña  1 , Maximilian Vondran  2 , Marc Irqsusi  3 , Holger Nef  4   5 , Ardawan J Rastan  1   3 , Tamer Ghazy  3
Affiliations

Combined Minimally Invasive Mitral Valve Surgery and Percutaneous Coronary Intervention: A Hybrid Concept for Patients with Mitral Valve and Coronary Pathologies

Martín Moscoso-Ludueña et al. J Clin Med. .

Abstract

We evaluated the feasibility of hybrid percutaneous coronary intervention (PCI) and minimally invasive mitral valve surgery (MIMVS) in patients with concomitant coronary and mitral disease. Of 534 patients who underwent MIMVS at our institution between 2012 and 2018, those with combined mitral and single vessel coronary pathologies who underwent MIMVS and PCI were included. Patients were excluded if they had endocarditis or required emergency procedures. Preprocedural, procedural, and postprocedural data were retrospectively analyzed. In total, 10 patients (median age, 75 years; 7 males) with a median ejection fraction (EF) of 60% were included. Nine patients underwent PCI before and one after MIMVS. The success rate was 100% in both procedures. There were no postoperative myocardial infarctions or strokes. Two patients developed delirium and one required re-thoracotomy for bleeding. The median stay in intensive care and the hospital was 3 and 8 days, respectively. The 30-day survival rate was 100%. A hybrid PCI and MIMVS approach is feasible in patients with mitral valve and single vessel coronary disease. In combined pathologies, the revascularization strategy should be evaluated independent from the mitral valve pathology in the presence of MIMVS expertise. Extension of this recommendation to multivessel disease should be evaluated in future studies.

Keywords: PCI; hybrid; minimally invasive; mitral valve.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Decision-making flowchart for patient selection. Abbreviations: CHD: coronary heart disease; MICS: minimally invasive cardiac surgery; CABG: coronary artery bypass grafting; ESC: European Society of Cardiology; LAD: left anterior descending artery; PCI: percutaneous coronary intervention; MIMVS: minimally invasive mitral valve surgery.
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