Minimally Invasive One-Stop Solution: CABG + LVAD Implantation at Peking University Third Hospital

For patients with end-stage heart failure, especially those with ischemic cardiomyopathy and severe multivessel coronary stenosis, conventional surgery often carries prohibitive risks due to poor cardiac reserve. Recently, the cardiac surgery team at Peking University Third Hospital (PKU 3rd Hospital), led by Professor Ling Yunpeng, innovatively performed a simultaneous minimally invasive CABG and Left Ventricular Assist Device (LVAD) implantation through a single small incision.

Patient Profile and Clinical Challenge: The 71-year-old male patient presented with end-stage heart failure, characterized by an Ejection Fraction (EF) of only 20% and an enlarged left ventricle (70mm). While multiple coronary arteries were severely stenosed, myocardial imaging suggested the presence of viable myocardium. This indicated the patient required both mechanical support to address the "power failure" and revascularization to facilitate potential heart function recovery.

The "One-Stop" Minimally Invasive Approach: Traditionally, such procedures require a full sternotomy. Professor Ling’s team opted for a more challenging but patient-centric minimally invasive route:

1. Single Small Incision: Utilizing a single intercostal incision on the left side, avoiding the trauma of traditional open-chest surgery.
2. Revascularization (CABG): Bypass vessels were precisely constructed to restore the "life line" of blood supply to the ischemic myocardium.
3. Artificial Heart Implantation (LVAD): Guided by real-time transesophageal echocardiography, the LVAD pump was implanted and connected in parallel with the patient’s natural heart to assist in blood circulation.

MDT Collaboration for Safety: Post-operatively, the intensive care team performed real-time adjustments of hemodynamic parameters and rotation speeds. When a severe epistaxis (nosebleed) occurred due to anticoagulation therapy, the hospital’s Multidisciplinary Team (MDT) responded immediately, with the Otolaryngology department performing endoscopic cauterization to stop the bleeding. After a month of refined care, the patient’s cardiorespiratory function significantly improved, leading to a full recovery and discharge.

Significance: This breakthrough procedure reduces surgical trauma and shortens recovery time, providing a new therapeutic pathway for end-stage heart failure patients who cannot undergo heart transplantation. PKU 3rd Hospital’s integration of complex techniques reaffirms its international standing in the management of critical cardiovascular diseases.