One-stage hybrid procedure: Association between awake minimally invasive surgical revascularization and percutaneous coronary intervention

Hybrid revascularization provides minimally invasive options for high-risk patients with multivessel coronary artery disease. We used a hybrid approach in two patients. The surgical revascularization with the left internal mammary artery (LIMA) on the left descending coronary artery was performed through an inferior j-shaped mini-sternotomy keeping the patients awake with high-epidural thoracic anesthesia. At the end of the operations the patients were moved to the angiography laboratory to complete the revascularization with angioplasty. No complications were reported.