Effect of hybrid treatment on rehabilitation and clinical condition of patients with multivessel coronary artery disease

Abstract

Introduction: Rehabilitation after coronary revascularization procedures is an intrinsic part of treatment during the in-hospital period. Objectives: We aimed to compare the course and effects of rehabilitation in patients receiving hybrid treatment (minimally invasive direct coronary artery bypass / percutaneous coronary intervention) or classic treatment (coronary artery bypass grafting / off-pump coronary artery bypass) during hospitalization. Patient s and methods: The study included 200 patients participating in a prospective randomized clinical trial (POLMIDES) that assessed the effect of hybrid treatment on in-hospital outcomes and long-term results in patients with multivessel coronary artery disease. Patients were divided into the classic and hybrid groups. Result s: The classic group showed a higher perioperative risk than the hybrid group (mean [SD] EuroSCORE, 3.54 [2.12] and 2.89 [1.97], respectively). During all the rehabilitation cycles, lower arterial oxygen saturation (SaO 2 ) was reported in the hybrid group (P = 0.002). The classic group showed lower systolic blood pressure (P <0.001), lower diastolic blood pressure (P = 0.029), and a higher rate of blood pressure drops during rehabilitation (P = 0.02). Patients from the classic group were able to sit (P <0.001), assume a vertical position (P <0.001), and walk (P = 0.01) earlier than those from the hybrid group. In the hybrid group, earlier completion of rehabilitation and discharge from the hospital were noted (P = 0.001). Conclusions: Patients receiving hybrid coronary revascularization less often suffer from hypotonia events but show lower SaO 2 values than patients receiving classic treatment. Mobilization of patients receiving the hybrid treatment is slower during the initial days and cycles of rehabilitation, but they achieve full self-reliance earlier, which enables a shorter hospitalization period. Copyright by Medycyna Praktyczna, Kraków 2018.