Eur Heart J Case Rep. 2026 Jun 1;10(6):ytag312. doi: 10.1093/ehjcr/ytag312. eCollection 2026 Jun.
ABSTRACT
BACKGROUND: Advances in anaesthesia and minimally invasive surgical techniques have expanded therapeutic options for patients with complex cardiac disease. While conventional open-heart surgery carries significant risks for this population, hybrid strategies offer a viable alternative.
CASE SUMMARY: We report the first case of concurrent hypertrophic obstructive cardiomyopathy (HOCM) and coronary artery disease (CAD) treated with a one-stage hybrid strategy: combining the Liwen procedure (echocardiography-guided percutaneous intramyocardial septal radiofrequency ablation) with minimally invasive direct coronary artery bypass (MIDCAB) via a single access. This approach effectively addressed both left ventricular outflow tract obstruction and myocardial ischaemia, while reducing trauma and accelerating recovery.
DISCUSSION: This case demonstrates that the concomitant Liwen procedure and MIDCAB through a single minimally invasive access is a feasible and promising strategy for patients with coexisting HOCM and CAD, offering reduced trauma and faster recovery compared to traditional approaches.
PMID:42233164 | PMC:PMC13225263 | DOI:10.1093/ehjcr/ytag312