Key result
An electrocoagulation-free MIDCAB procedure was successfully performed in a multimorbid patient with a cochlear implant, with no haemostatic issues or excessive bleeding at 1-year follow-up.
Why the study?
Hybrid coronary revascularisation benefits patients with multivessel disease, but performing a MIDCAB procedure without electrocoagulation was required for a multimorbid patient with a cochlear implant.
Case Report (n=1)
No
An electrocoagulation-free MIDCAB procedure is feasible and safe in selected multimorbid patients, offering a viable revascularization strategy when electrosurgery is contraindicated, such as in patients with cochlear implants.
Answers are grounded in this paper and cite their sources.
Hybrid revascularisation may be feasible in selected left main disease; leaves open its role pending prospective trials.
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.
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Schuering et al. (2025) conducted a case report in Multivessel coronary artery disease (n=1). Electrocoagulation-free minimally invasive direct coronary artery bypass (MIDCAB) was evaluated on Surgical success and haemostasis. An electrocoagulation-free MIDCAB procedure was successfully performed in a multimorbid patient with a cochlear implant, with no haemostatic issues or excessive bleeding at 1-year follow-up.
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