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

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.
PATIENTS 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.
RESULTS    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 (SaO2) 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 SaO2 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.