For certain patients who have coronary artery disease and heart valve disease, new pioneering hybrid therapies can replace two traditional procedures by a combination of less invasive procedures performed in the cardiac catheterization laboratory and the operating room.
The Cardiovascular Center at Brigham and Women’s Hospital is one of only a few centers in the country performing hybrid cardiovascular therapies. Hybrid therapy for coronary artery disease and heart valve disease involves two procedures, vascular stenting and minimally invasive heart valve surgery.
- Stenting is a non-surgical procedure used to treat coronary artery disease. People with coronary artery disease experience thickening of their artery walls leading to blockages, have a higher risk of heart attack and often suffer from chest pain. The stenting procedure, performed in a cardiac catheterization laboratory, involves a long, slender tube that is inserted through a blood vessel and guided to the heart. As dye is injected through the arteries to guide the cardiologist, a stent is inserted to open the blocked artery and restore normal blood supply to the heart.
- Heart valve surgery is performed to replace or repair valves that are not working properly. This surgery can be performed minimally invasively through an incision much smaller than that of conventional surgery with less trauma and blood loss, a smaller scar, decreased pain and a speedier recovery.
Benefits of Hybrid Therapy
The main advantages of hybrid therapy over traditional open-heart bypass and valve surgeries are reduction in both operating time and recovery time for patients.
For most patients, both the angioplasty and the minimally invasive heart surgery can be performed in one day – requiring only one hospital stay lasting three to four days. Hybrid therapies provide an even greater benefit to fragile, elderly and other high-risk patients. It is expected that, as the overall population ages, the demand for less traumatic hybrid therapies will grow dramatically.
Only a cardiac specialist can determine the best course of treatment for a patient who has coronary artery disease and heart valve disease and whether that person may be an appropriate candidate for hybrid therapy.
Hybrid Therapy for Other Cardiovascular Conditions
Along with treatment for patients with coronary artery disease and heart valve disease, hybrid therapies are being used to a lesser degree for patients with other cardiovascular conditions including irregular heartbeats (arrhythmias) and thoracic aneurysm repair.
Also, within the next few years it is expected that the Food and Drug Administration (FDA) will approve non-surgical catheter-based techniques for heart valve repair (now being performed experimentally at a handful of centers including Brigham and Women’s Hospital) as an alternative to a surgical procedure.
Ongoing Research Leads to Innovative Cardiac Care
At the forefront in cardiovascular research, experts in the Brigham and Women’s Cardiovascular Center are pioneering studies that are researching the effectiveness of hybrid therapies for other heart disease treatments and the added benefits that these types of approaches can provide.
One Brigham and Women’s Hospital study, published in the January 4, 2005 issue of the Journal of the American College of Cardiology, looked at more complex cases of coronary artery disease and heart valve disease. The study showed that an initial coronary stenting procedure followed by valve surgery was an excellent, possibly life-saving, alternative to conventional high-risk coronary artery bypass grafting (CABG)/valve surgery in patients whose blockages of the heart arteries are discovered with few prior symptoms. The study showed that hybrid therapies also may be appropriate for certain patients who are to undergo a second valve surgery several years after their first such operation.
Findings from these and other studies will lead to clinical and technological advances that will offer better treatment options for patients, involving even less invasive approaches. In the next few years, many more cardiac procedures will be performed in the operating room as hybrid procedures – combining the disciplines of cardiac surgery, interventional cardiology and cardiology.
Lawrence H. Cohn, Chief, Division of Cardiac Surgery, Brigham and Women’s Hospital; Frederic Resnic, MD, MSc, Director, Cardiac Catheterization Laboratory, Brigham and Women’s Hospital.
Cardiovascular Center at Brigham and Women’s Hospital
The Cardiovascular Center leads the way in providing comprehensive care across the full spectrum of cardiovascular disease areas, including treatment of the most complex disorders of the heart, vessels and circulatory system. The renowned experts of Brigham and Women’s Hospital developed many of the innovative, state-of-the-art diagnostic tools, therapies and technologies being used every day within the Center. Brigham and Women’s Hospital is consistently ranked among the best hospitals in the country in just about every specialty, including cardiac surgery, cardiovascular medicine and vascular surgery.
For more information or to make an appointment, call 1-877-BWF-5773.
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Our Cardiovascular Center provides comprehensive state-of-the-art care for the full range of cardiovascular diseases.
