Maryland Heart Center

Minimally Invasive Coronary Bypass Surgery

Hybrid Coronary Intervention

Hybrid procedure recognized as a 2005 "Innovation of the Year" by the Daily Record, a Maryland business journal

What is the hybrid procedure?

Our operating room is both a fully equipped surgical suite and a state-of-the-art cardiac catheterization laboratory in the same room. This "Hybrid OR" is a place where cardiac surgeons and interventional cardiologists cooperate in order to achieve an optimal result for the patient.

The hybrid procedure is an innovative approach to double- or triple-vessel coronary artery disease. The hybrid approach combines minimally invasive coronary artery bypass surgery (TECAB or MIDCAB) with catheter-based coronary intervention (PTCA, stenting).

The rationale for this approach is that the internal mammary artery, which can be placed in minimally invasive fashion, is the best choice for the anterior wall of the heart. Under protection of this bypass graft the other vessels are stented.

When the bypass surgery is complete, a cardiologist takes over with angioplasty to restore normal blood flow in arteries not blocked enough to require a bypass. To reduce the chance that the blockage will recur, coated stents are used. The stents are coated with a medication that prevents reblocking, also known as restenosis.

Although the procedures are not new, the fact that they are combined is. In fact, the University of Maryland Medical Center is among the first hospitals in the U.S. to do the combined procedure in the same operating room. Until now, patients needing both procedures would have bypass surgery first and then angioplasty a day or two later or the reverse.

The hybrid procedure combines the best of both worlds -- bypass surgery and stenting -- by using a minimally invasive surgical procedure that has longevity and using stents for what they are best at, which is taking care of non-left anterior descending (LAD) vessels.

The team at the University of Maryland is working on advanced hybrid procedures in which multiple blockages of the coronary artery system are treated using a combination of endoscopic surgery- and catheter-based intervention.

What are the other advantages of the simultaneous hybrid procedure?

This approach benefits patients because it is more convenient and less stressful to have both bypass surgery and stenting performed at the same time, rather than on separate days.
The procedure is carried out with the complete safety net of a cardiac surgery operating room.
Another advantage for patients is that this type of bypass surgery can be performed without a major incision. It's a less invasive procedure with improved chances for long-term success.
Patients can also expect quicker recovery times and reduced hospital stays.

Who is a good candidate for the hybrid procedure?

Ideal candidates for the hybrid procedure have a blockage in a major vessel called the left anterior descending (LAD) artery, which supplies 60 percent of the blood to the heart, as well as blockages in non-LAD arteries that can be treated with a stent.

Why should patients come to the Maryland Heart Center?

the University of Maryland Medical Center is among the first hospitals in the U.S. to do the combined procedure in the same operating room, and our doctors have played a pioneering role in this area.

Our operating room is both a fully equipped surgical suite and a state-of-the-art cardiac catheterization laboratory in the same room. We are one of the only hospitals in the area to have this combined OR and one of the first in the nation to perform the hybrid procedure.

This combined OR presents a tremendous advantage, because if for some reason doctors are unable to get a satisfactory result from the angioplasty side, then they can convert to an open bypass operation. The patient won't have to be moved to another room because they will already be in an operating room, which is equipped with a heart-lung machine. The hybrid operating room is a high-tech treatment unit that can definitely be regarded as the operating room of the future.

The University of Maryland Medical Center is proud of having surgeons and interventional cardiologists who cooperate in order to obtain a perfect therapy concept for the patient.

Please call if you would like to make an appointment or talk to someone about our services. Patients dial 1-866-408-6885, physicians dial 410-328-6622 or 1-800-318-1019.