Anaesthesia for hybrid revascularisation and valve replacement in a high-risk patient

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Abstract
Hybrid procedures offer a promising solution for complex cases where open surgery is high risk, relying on the collaboration of anaesthesiologists, cardiac surgeons and interventional cardiologists. We present a male patient in his 70s with severe aortic stenosis, coronary artery disease, ascending aortic aneurysm and heart failure who underwent a hybrid cardiac procedure, including transcatheter aortic valve implantation, percutaneous coronary intervention of the right coronary artery and coronary artery bypass graft surgery. Through this hybrid intervention, involving a minimally invasive transcatheter and an open surgical procedure, the patient remained haemodynamically stable with minimal blood loss. 6 months postprocedure, he showed significant improvement in daily activities, aided by consistent physical therapy and cardiac check-ups. Current literature supports the hybrid approach for optimising risk-benefit outcomes, though further research is needed to define precise indications for its use.

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