Abstract
We report the case of a 78-year old male patient with severe pectus excavatum and ischaemic heart disease. He had CCS Class III angina and a significant finding on coronary angiography.
The patient was indicated for myocardial revascularization. Additionally, the patient suffered from rheumatoid arthritis treated by corticosteroids and methotrexate.
Given the high risk of impaired healing of the sternotomy and subsequent infection, the patient was scheduled for so-called hybrid revascularization, involving coronary bypass using small anterior thoracotomy followed by percutaneous coronary intervention (PCI). This procedure is a valuable alternative to standard CABG in patients with multivessel disease who are at high risk for sternotomy-related complications.