Prospective Evaluation for Hybrid Cardiac Procedures

NCT ID: NCT05143671

Last Updated: 2025-08-14

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 134 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2021-05-13
• Study Completion Date: 2025-07-30

Brief Summary

Multidisciplinary team-approach in order to offer personalized treatments represents the emerging mainstream in cardiovascular medicine. "Hybrid operative rooms" allow to offer selected heart-disease patients truly "tailored" operations.

This study wants to evaluate the effectiveness and safety of Hybrid Procedures in cardiac patients in three subgroups of patients:

• Hybrid coronary revascularization strategy (coronary by-pass + PCI);
• Hybrid valve and coronary disease correction (combination of surgical valve replacement and PCI);
• Hybrid coronary and carotid artery disease treatment (combination of coronary by-pass and carotid stenting).

The investigators hypothesize that morbidity might be reduced by 50% in hybrid procedures group as compared with predicted Society of Thoracic Surgery (STS) score.

Detailed Description

Cardiovascular medicine is actually evolving fast and multidisciplinary team-approach in order to offer personalized treatments represents the emerging mainstream. The possibility to realize combinations of treatments traditionally available only in the catheterization laboratory and in the operating room represent the rationale for "hybrid operative rooms" facilities allowing to offer selected heart-disease patients truly "tailored" operations. Such "Hybrid" management strategies usually combine transcatheter techniques and surgery (often minimally invasive) in order to combine the reduced invasiveness of the former with the effectiveness of the latter. Common examples of surgical and transcatheter combinations are: hybrid revascularization performed with coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI); combined heart valve and coronary disease treated with valve surgery and PCI; combined endo- and epicardial ablation of atrial fibrillation; thoracic aneurysms treated with endovascular stenting and surgical debranching of the arch; carotid artery stenting along with CABG. Given the relatively recent development of these techniques, indications and patient selection are yet to be defined and a productive collaboration between surgeons and interventional cardiologists is of paramount importance.

Aim of the study is to evaluate the effectiveness and safety of Hybrid Procedures in cardiac patients. Specifically, three subgroups will be analysed:

• Hybrid coronary revascularization strategy (HCR, coronary by-pass + PCI);
• Hybrid valve and coronary disease correction (combination of surgical valve replacement and PCI);
• Hybrid coronary and carotid artery disease treatment (combination of coronary by-pass and carotid stenting).

The local Heart Team (cardiac surgeon, interventional cardiologist, clinical cardiologist and anaesthetist) will decide which patients will be referred for hybrid treatment. Typically, this happens when the Heart Team feels that hybrid treatment could reduce the overall risk of a combined procedure.

The patient population consists of adult patients with:

• Multi-vessel coronary artery disease (CAD) involving the left main and/or the left anterior descending artery with indication for revascularization;
• Severe, symptomatic valvular disease and CAD with indication for revascularization;
• Significant unilateral carotid stenosis and CAD with indication for revascularization.

In a previous data review board on the Heart Team activity, we recognized that 10% of discussed patients are referred for hybrid procedures (HP) and that observed operative mortality was strongly lower than that predicted by STS and EuroSCORE (2.5% versus 10.1% and 5.9%, respectively). Morbidity was not prospectively investigated. For sample size estimation, the investigators hypothesized that Morbidity might be reduced by 50% in HP group as compared with predicted STS. The mean expected STS morbidity estimated in the study population is 32.57%. Accordingly, a total number of 111 patients with an alpha error of 5% and a beta error of 20% has been calculated to be needed to test this hypothesis.

Conditions

Left Main Coronary Artery Disease; Left Anterior Descending Coronary Artery Stenosis; Valve Disease, Heart; Carotid Stenosis; Coronary Artery Disease; Heart Diseases; Heart Valve Diseases; Carotid Occlusion

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: PROSPECTIVE

Study Groups

Hybrid coronary revascularization strategy (HCR)

Patients who undergo a combination of coronary artery bypass grafting and PCI.

Coronary artery bypass grafting

Intervention Type: PROCEDURE

Coronary artery bypass grafting in coronary revascularization.

Percutaneous coronary intervention

Intervention Type: PROCEDURE

Percutaneous coronary intervention in coronary revascularization.

Hybrid valve and coronary disease correction

Patients who undergo a combination of surgical valve replacement and PCI.

Percutaneous coronary intervention

Intervention Type: PROCEDURE

Percutaneous coronary intervention in coronary revascularization.

Surgical valve replacement

Intervention Type: PROCEDURE

Surgical mitral and / or aortic valve replacement.

Hybrid coronary and carotid artery disease treatment

Patients who undergo a combination of coronary artery bypass grafting and carotid stenting.

Coronary artery bypass grafting

Intervention Type: PROCEDURE

Coronary artery bypass grafting in coronary revascularization.

Carotid artery stenting

Intervention Type: PROCEDURE

Carotid artery stenting.

Interventions

Coronary artery bypass grafting

Coronary artery bypass grafting in coronary revascularization.

Intervention Type: PROCEDURE

Percutaneous coronary intervention

Percutaneous coronary intervention in coronary revascularization.

Intervention Type: PROCEDURE

Surgical valve replacement

Surgical mitral and / or aortic valve replacement.

Intervention Type: PROCEDURE

Carotid artery stenting

Carotid artery stenting.

Intervention Type: PROCEDURE

Eligibility Criteria

Inclusion Criteria

• Signed informed consent, inclusive of release of medical information
• Age ≥ 18 years
• CAD with indication for revascularization
• Coronary anatomy as follows:

• Multivessel-CAD involving the left anterior descending (LAD) (proximal or mid) and/or the left main (LM) (ostial, mid-shaft or distal) with at least one further epicardial coronary artery requiring treatment (LCX or RCA), OR
• Single vessel disease involving the LAD and a major diagonal, both requiring independent revascularization with at least one stent
• Severe aortic stenosis/insufficiency and/or mitral stenosis/insufficiency requiring surgery, with CAD (involving one or more vessels), suitable for PCI
• CAD with indication for revascularization with severe unilateral carotid stenosis (>85%)
• Ability to tolerate, and no plans to interrupt dual antiplatelet therapy (DAPT) for:

• At least 6 months in presentation was stable CAD,
• At least 12 months if presentation was a biomarker-positive acute coronary syndrome (ACS)
• Willing to comply with the follow-up required by the protocol.

Exclusion Criteria

• Previous cardiac surgery of any kind
• Previous thoracic surgery involving the left pleural space (if a left thoracotomy approach is planned)
• Complicated or unsuccessful PCI within 30 days prior
• Total occlusion (TIMI 0 or 1 flow) of the LM or LAD
• Cardiogenic shock at time of screening
• Any prior lung resection
• End-stage renal disease on dialysis
• Extra-cardiac illness that is expected to limit survival to less then 5 years
• Allergy or hypersensitivity to any of the study drugs or devices used in protocol
• Patient unable to give informed consent or potentially noncompliant with the study protocol, in the judgement of the investigator
• Pregnant at time of screening, or unwilling to use effective birth control measures while dual antiplatelet therapy is required.

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Fondazione Policlinico Universitario Agostino Gemelli IRCCS

OTHER

Sponsor Role: lead

Responsible Party

Dr. Bruno

Clinical Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Piergiorgio Bruno, MD

Role: PRINCIPAL_INVESTIGATOR

Locations

IRCCS Fondazione Policlinico Universitario Agostino Gemelli

Roma, , Italy

Countries

Italy

References

Byrne JG, Leacche M, Vaughan DE, Zhao DX. Hybrid cardiovascular procedures. JACC Cardiovasc Interv. 2008 Oct;1(5):459-68. doi: 10.1016/j.jcin.2008.07.002.

Reference Type: BACKGROUND

PMID: 19463346 (View on PubMed)

Leacche M, Umakanthan R, Zhao DX, Byrne JG. Surgical update: hybrid procedures, do they have a role? Circ Cardiovasc Interv. 2010 Oct;3(5):511-8. doi: 10.1161/CIRCINTERVENTIONS.110.957951. No abstract available.

Reference Type: BACKGROUND

PMID: 20959598 (View on PubMed)

Loop FD, Lytle BW, Cosgrove DM, Stewart RW, Goormastic M, Williams GW, Golding LA, Gill CC, Taylor PC, Sheldon WC, et al. Influence of the internal-mammary-artery graft on 10-year survival and other cardiac events. N Engl J Med. 1986 Jan 2;314(1):1-6. doi: 10.1056/NEJM198601023140101.

Reference Type: BACKGROUND

PMID: 3484393 (View on PubMed)

Diegeler A, Thiele H, Falk V, Hambrecht R, Spyrantis N, Sick P, Diederich KW, Mohr FW, Schuler G. Comparison of stenting with minimally invasive bypass surgery for stenosis of the left anterior descending coronary artery. N Engl J Med. 2002 Aug 22;347(8):561-6. doi: 10.1056/NEJMoa013563.

Reference Type: BACKGROUND

PMID: 12192015 (View on PubMed)

Lytle BW, Cosgrove DM, Loop FD, Borsh J, Goormastic M, Taylor PC. Perioperative risk of bilateral internal mammary artery grafting: analysis of 500 cases from 1971 to 1984. Circulation. 1986 Nov;74(5 Pt 2):III37-41.

Reference Type: BACKGROUND

PMID: 3490331 (View on PubMed)

Tatoulis J, Buxton BF, Fuller JA. Patencies of 2127 arterial to coronary conduits over 15 years. Ann Thorac Surg. 2004 Jan;77(1):93-101. doi: 10.1016/s0003-4975(03)01331-6.

Reference Type: BACKGROUND

PMID: 14726042 (View on PubMed)

Ben-Gal Y, Mohr R, Braunstein R, Finkelstein A, Hansson N, Hendler A, Moshkovitz Y, Uretzky G. Revascularization of left anterior descending artery with drug-eluting stents: comparison with minimally invasive direct coronary artery bypass surgery. Ann Thorac Surg. 2006 Dec;82(6):2067-71. doi: 10.1016/j.athoracsur.2006.06.041.

Reference Type: BACKGROUND

PMID: 17126111 (View on PubMed)

Fraund S, Herrmann G, Witzke A, Hedderich J, Lutter G, Brandt M, Boning A, Cremer J. Midterm follow-up after minimally invasive direct coronary artery bypass grafting versus percutaneous coronary intervention techniques. Ann Thorac Surg. 2005 Apr;79(4):1225-31. doi: 10.1016/j.athoracsur.2004.08.082.

Reference Type: BACKGROUND

PMID: 15797053 (View on PubMed)

Alexander JH, Hafley G, Harrington RA, Peterson ED, Ferguson TB Jr, Lorenz TJ, Goyal A, Gibson M, Mack MJ, Gennevois D, Califf RM, Kouchoukos NT; PREVENT IV Investigators. Efficacy and safety of edifoligide, an E2F transcription factor decoy, for prevention of vein graft failure following coronary artery bypass graft surgery: PREVENT IV: a randomized controlled trial. JAMA. 2005 Nov 16;294(19):2446-54. doi: 10.1001/jama.294.19.2446.

Reference Type: BACKGROUND

PMID: 16287955 (View on PubMed)

Moses JW, Leon MB, Popma JJ, Fitzgerald PJ, Holmes DR, O'Shaughnessy C, Caputo RP, Kereiakes DJ, Williams DO, Teirstein PS, Jaeger JL, Kuntz RE; SIRIUS Investigators. Sirolimus-eluting stents versus standard stents in patients with stenosis in a native coronary artery. N Engl J Med. 2003 Oct 2;349(14):1315-23. doi: 10.1056/NEJMoa035071.

Reference Type: BACKGROUND

PMID: 14523139 (View on PubMed)

Harskamp RE, Zheng Z, Alexander JH, Williams JB, Xian Y, Halkos ME, Brennan JM, de Winter RJ, Smith PK, Lopes RD. Status quo of hybrid coronary revascularization for multi-vessel coronary artery disease. Ann Thorac Surg. 2013 Dec;96(6):2268-77. doi: 10.1016/j.athoracsur.2013.07.093.

Reference Type: BACKGROUND

PMID: 24446561 (View on PubMed)

Mauri L, Orav EJ, Kuntz RE. Late loss in lumen diameter and binary restenosis for drug-eluting stent comparison. Circulation. 2005 Jun 28;111(25):3435-42. doi: 10.1161/CIRCULATIONAHA.104.513952. Epub 2005 Jun 20.

Reference Type: BACKGROUND

PMID: 15967844 (View on PubMed)

Leacche M, Byrne JG, Solenkova NS, Reagan B, Mohamed TI, Fredi JL, Zhao DX. Comparison of 30-day outcomes of coronary artery bypass grafting surgery verus hybrid coronary revascularization stratified by SYNTAX and euroSCORE. J Thorac Cardiovasc Surg. 2013 Apr;145(4):1004-1012. doi: 10.1016/j.jtcvs.2012.03.062. Epub 2012 Apr 25.

Reference Type: BACKGROUND

PMID: 22541514 (View on PubMed)

Harskamp RE, Brennan JM, Xian Y, Halkos ME, Puskas JD, Thourani VH, Gammie JS, Taylor BS, de Winter RJ, Kim S, O'Brien S, Peterson ED, Gaca JG. Practice patterns and clinical outcomes after hybrid coronary revascularization in the United States: an analysis from the society of thoracic surgeons adult cardiac database. Circulation. 2014 Sep 9;130(11):872-9. doi: 10.1161/CIRCULATIONAHA.114.009479. Epub 2014 Jul 23.

Reference Type: BACKGROUND

PMID: 25055814 (View on PubMed)

Verhaegh AJ, Accord RE, van Garsse L, Maessen JG. Hybrid coronary revascularization as a safe, feasible, and viable alternative to conventional coronary artery bypass grafting: what is the current evidence? Minim Invasive Surg. 2013;2013:142616. doi: 10.1155/2013/142616. Epub 2013 Apr 3.

Reference Type: BACKGROUND

PMID: 23691303 (View on PubMed)

Wrigley BJ, Dubey G, Spyt T, Gershlick AH. Hybrid revascularisation in multivessel coronary artery disease: could a combination of CABG and PCI be the best option in selected patients? EuroIntervention. 2013 Mar;8(11):1335-41. doi: 10.4244/EIJV8I11A202. No abstract available.

Reference Type: BACKGROUND

PMID: 23538160 (View on PubMed)

Green KD, Lynch DR Jr, Chen TP, Zhao D. Combining PCI and CABG: the role of hybrid revascularization. Curr Cardiol Rep. 2013 Apr;15(4):351. doi: 10.1007/s11886-013-0351-9.

Reference Type: BACKGROUND

PMID: 23420447 (View on PubMed)

Santana O, Funk M, Zamora C, Escolar E, Lamas GA, Lamelas J. Staged percutaneous coronary intervention and minimally invasive valve surgery: results of a hybrid approach to concomitant coronary and valvular disease. J Thorac Cardiovasc Surg. 2012 Sep;144(3):634-9. doi: 10.1016/j.jtcvs.2011.11.008. Epub 2011 Dec 10.

Reference Type: BACKGROUND

PMID: 22154788 (View on PubMed)

Santana O, Pineda AM, Cortes-Bergoderi M, Mihos CG, Beohar N, Lamas GA, Lamelas J. Hybrid approach of percutaneous coronary intervention followed by minimally invasive valve operations. Ann Thorac Surg. 2014 Jun;97(6):2049-55. doi: 10.1016/j.athoracsur.2014.02.039. Epub 2014 Apr 13.

Reference Type: BACKGROUND

PMID: 24725838 (View on PubMed)

Byrne JG, Leacche M, Unic D, Rawn JD, Simon DI, Rogers CD, Cohn LH. Staged initial percutaneous coronary intervention followed by valve surgery ("hybrid approach") for patients with complex coronary and valve disease. J Am Coll Cardiol. 2005 Jan 4;45(1):14-8. doi: 10.1016/j.jacc.2004.09.050.

Reference Type: BACKGROUND

PMID: 15629366 (View on PubMed)

Versaci F, Reimers B, Del Giudice C, Schofer J, Giacomin A, Sacca S, Gandini R, Albiero R, Pellegrino A, Bertoldo F, Simonetti G, Chiariello L. Simultaneous hybrid revascularization by carotid stenting and coronary artery bypass grafting: the SHARP study. JACC Cardiovasc Interv. 2009 May;2(5):393-401. doi: 10.1016/j.jcin.2009.02.010.

Reference Type: BACKGROUND

PMID: 19463460 (View on PubMed)

Velissaris I, Kiskinis D, Anastasiadis K. Synchronous carotid artery stenting and open heart surgery. J Vasc Surg. 2011 May;53(5):1237-41. doi: 10.1016/j.jvs.2010.11.049. Epub 2011 Jan 17.

Reference Type: BACKGROUND

PMID: 21247729 (View on PubMed)

Chiariello L, Nardi P, Pellegrino A, Saitto G, Chiariello GA, Russo M, Zeitani J, Versaci F. Simultaneous carotid artery stenting and heart surgery: expanded experience of hybrid surgical procedures. Ann Thorac Surg. 2015 Apr;99(4):1291-7. doi: 10.1016/j.athoracsur.2014.11.043. Epub 2015 Feb 7.

Reference Type: BACKGROUND

PMID: 25661578 (View on PubMed)

Mendiz OA, Fava CM, Lev GA, Valdivieso LR, Caponi G, Hidalgo Alava GF, Favaloro RR. Hybrid strategy for unstable patients with severe carotid and cardiac disease requiring surgery. Cardiol J. 2015;22(1):25-30. doi: 10.5603/CJ.a2014.0001. Epub 2014 Feb 14.

Reference Type: BACKGROUND

PMID: 24526504 (View on PubMed)

Chiariello L, Tomai F, Zeitani J, Versaci F. Simultaneous hybrid revascularization by carotid stenting and coronary artery bypass grafting. Ann Thorac Surg. 2006 May;81(5):1883-5. doi: 10.1016/j.athoracsur.2005.04.086.

Reference Type: BACKGROUND

PMID: 16631695 (View on PubMed)

Wu H, Sun H, Jiang X, Ma W, Wang X, Zhang J, Hu S. Simultaneous hybrid revascularization by peripheral artery stenting and off-pump coronary artery bypass: the early results. Ann Thorac Surg. 2011 Mar;91(3):661-4. doi: 10.1016/j.athoracsur.2010.10.057.

Reference Type: BACKGROUND

PMID: 21352975 (View on PubMed)

Yang T, Zhang L, Wang X, Dong H, Jiang X, Sun H. Revascularization by carotid artery stenting and off-pump coronary artery bypass. ANZ J Surg. 2016 Jul;86(7-8):602-7. doi: 10.1111/ans.12586. Epub 2014 Apr 3.

Reference Type: BACKGROUND

PMID: 24698016 (View on PubMed)

Van der Heyden J, Van Neerven D, Sonker U, Bal ET, Kelder JC, Plokker HW, Suttorp MJ. Carotid artery stenting and cardiac surgery in symptomatic patients. JACC Cardiovasc Interv. 2011 Nov;4(11):1190-6. doi: 10.1016/j.jcin.2011.07.012.

Reference Type: BACKGROUND

PMID: 22115658 (View on PubMed)

Versaci F, Del Giudice C, Scafuri A, Zeitani J, Gandini R, Nardi P, Salvati A, Pampana E, Sebastiano F, Romagnoli A, Simonetti G, Chiariello L. Sequential hybrid carotid and coronary artery revascularization: immediate and mid-term results. Ann Thorac Surg. 2007 Nov;84(5):1508-13; discussion 1513-4. doi: 10.1016/j.athoracsur.2007.05.048.

Reference Type: BACKGROUND

PMID: 17954054 (View on PubMed)

O'Brien SM, Shahian DM, Filardo G, Ferraris VA, Haan CK, Rich JB, Normand SL, DeLong ER, Shewan CM, Dokholyan RS, Peterson ED, Edwards FH, Anderson RP; Society of Thoracic Surgeons Quality Measurement Task Force. The Society of Thoracic Surgeons 2008 cardiac surgery risk models: part 2--isolated valve surgery. Ann Thorac Surg. 2009 Jul;88(1 Suppl):S23-42. doi: 10.1016/j.athoracsur.2009.05.056.

Reference Type: BACKGROUND

PMID: 19559823 (View on PubMed)

Mehran R, Rao SV, Bhatt DL, Gibson CM, Caixeta A, Eikelboom J, Kaul S, Wiviott SD, Menon V, Nikolsky E, Serebruany V, Valgimigli M, Vranckx P, Taggart D, Sabik JF, Cutlip DE, Krucoff MW, Ohman EM, Steg PG, White H. Standardized bleeding definitions for cardiovascular clinical trials: a consensus report from the Bleeding Academic Research Consortium. Circulation. 2011 Jun 14;123(23):2736-47. doi: 10.1161/CIRCULATIONAHA.110.009449. No abstract available.

Reference Type: BACKGROUND

PMID: 21670242 (View on PubMed)

Ware J Jr, Kosinski M, Keller SD. A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996 Mar;34(3):220-33. doi: 10.1097/00005650-199603000-00003.

Reference Type: BACKGROUND

PMID: 8628042 (View on PubMed)

Rockville, MD. Calculating the U.S. Population-based EQ-5D Index Score: Research Initiative in Clinical Economics. February 2005. Agency for Healthcare Research and Quality, http://archive.ahrq.gov/professionals/clinicians-providers/resources/rice/EQ5Dscore.html

Reference Type: BACKGROUND

Thygesen K, Alpert JS, White HD; Joint ESC/ACCF/AHA/WHF Task Force for the Redefinition of Myocardial Infarction; Jaffe AS, Apple FS, Galvani M, Katus HA, Newby LK, Ravkilde J, Chaitman B, Clemmensen PM, Dellborg M, Hod H, Porela P, Underwood R, Bax JJ, Beller GA, Bonow R, Van der Wall EE, Bassand JP, Wijns W, Ferguson TB, Steg PG, Uretsky BF, Williams DO, Armstrong PW, Antman EM, Fox KA, Hamm CW, Ohman EM, Simoons ML, Poole-Wilson PA, Gurfinkel EP, Lopez-Sendon JL, Pais P, Mendis S, Zhu JR, Wallentin LC, Fernandez-Aviles F, Fox KM, Parkhomenko AN, Priori SG, Tendera M, Voipio-Pulkki LM, Vahanian A, Camm AJ, De Caterina R, Dean V, Dickstein K, Filippatos G, Funck-Brentano C, Hellemans I, Kristensen SD, McGregor K, Sechtem U, Silber S, Tendera M, Widimsky P, Zamorano JL, Morais J, Brener S, Harrington R, Morrow D, Lim M, Martinez-Rios MA, Steinhubl S, Levine GN, Gibler WB, Goff D, Tubaro M, Dudek D, Al-Attar N. Universal definition of myocardial infarction. Circulation. 2007 Nov 27;116(22):2634-53. doi: 10.1161/CIRCULATIONAHA.107.187397. Epub 2007 Oct 19. No abstract available.

Reference Type: BACKGROUND

PMID: 17951284 (View on PubMed)

Moussa ID, Klein LW, Shah B, Mehran R, Mack MJ, Brilakis ES, Reilly JP, Zoghbi G, Holper E, Stone GW. Consideration of a new definition of clinically relevant myocardial infarction after coronary revascularization: an expert consensus document from the Society for Cardiovascular Angiography and Interventions (SCAI). J Am Coll Cardiol. 2013 Oct 22;62(17):1563-70. doi: 10.1016/j.jacc.2013.08.720.

Reference Type: BACKGROUND

PMID: 24135581 (View on PubMed)

Valgimigli M, Bueno H, Byrne RA, Collet JP, Costa F, Jeppsson A, Juni P, Kastrati A, Kolh P, Mauri L, Montalescot G, Neumann FJ, Petricevic M, Roffi M, Steg PG, Windecker S, Zamorano JL, Levine GN; ESC Scientific Document Group; ESC Committee for Practice Guidelines (CPG); ESC National Cardiac Societies. 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS: The Task Force for dual antiplatelet therapy in coronary artery disease of the European Society of Cardiology (ESC) and of the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2018 Jan 14;39(3):213-260. doi: 10.1093/eurheartj/ehx419. No abstract available.

Reference Type: BACKGROUND

PMID: 28886622 (View on PubMed)

Sousa-Uva M, Neumann FJ, Ahlsson A, Alfonso F, Banning AP, Benedetto U, Byrne RA, Collet JP, Falk V, Head SJ, Juni P, Kastrati A, Koller A, Kristensen SD, Niebauer J, Richter DJ, Seferovic PM, Sibbing D, Stefanini GG, Windecker S, Yadav R, Zembala MO; ESC Scientific Document Group. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur J Cardiothorac Surg. 2019 Jan 1;55(1):4-90. doi: 10.1093/ejcts/ezy289. No abstract available.

Reference Type: BACKGROUND

PMID: 30165632 (View on PubMed)

Fujita B, Ensminger S, Bauer T, Mollmann H, Beckmann A, Bekeredjian R, Bleiziffer S, Schafer E, Hamm CW, Mohr FW, Katus HA, Harringer W, Walther T, Frerker C; GARY Executive Board. Trends in practice and outcomes from 2011 to 2015 for surgical aortic valve replacement: an update from the German Aortic Valve Registry on 42 776 patients. Eur J Cardiothorac Surg. 2018 Mar 1;53(3):552-559. doi: 10.1093/ejcts/ezx408.

Reference Type: BACKGROUND

PMID: 29190355 (View on PubMed)

Other Identifiers

3959

Identifier Type: -

Identifier Source: org_study_id