Advanced Hybrid Complete Revascularization with TECAB and Impella-Assisted PCI of CTO

Cardiovasc Revasc Med. 2019 Nov;20(11S):51-54. doi: 10.1016/j.carrev.2019.03.014. Epub 2019 Mar 21.


An 80-year-old man was referred for multi-vessel coronary artery disease with baseline SYNTAX score of 45 after evaluation for persistent stable angina. He underwent complete hybrid revascularization combining total endoscopic coronary artery bypass utilizing bilateral internal mammary arteries (IMA) with sequential LIMA to left anterior descending artery and diagonal arteries, and RIMA to obtuse marginal after Impella-assisted chronic total occlusion percutaneous coronary intervention of the right coronary artery. This represents a successful case of advanced hybrid coronary revascularization.

Keywords: Chronic total occlusion; Complete revascularization; Complex and higher risk percutaneous coronary intervention; Hemodynamic support; Hybrid revascularization; Totally endoscopic coronary artery bypass.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Angioplasty, Balloon, Coronary*
  • Chronic Disease
  • Coronary Artery Bypass / methods*
  • Coronary Occlusion / diagnostic imaging
  • Coronary Occlusion / physiopathology
  • Coronary Occlusion / therapy*
  • Endoscopy*
  • Heart-Assist Devices*
  • Hemodynamics*
  • Humans
  • Male
  • Treatment Outcome
  • Vascular Calcification / diagnostic imaging
  • Vascular Calcification / physiopathology
  • Vascular Calcification / therapy*
  • Ventricular Function, Left*