A second unique advantage of the hybrid operating environment is in providing less-invasive therapeutic options. As in our patient, surgical graft revision would have required a second period of cardiopulmonary bypass and aortic clamping, and this was avoided by electing to perform a less-invasive percutaneous intervention. This resulted in a dramatic improvement in the graft flow and distal runoff with recruitment of collaterals and immediate resolution of the patient's mitral regurgitation. Moreover, the hybrid environment will undoubtedly lead to more liberal use of minimally invasive valve operations combined with percutaneous coronary interventions and combined surgical and percutaneous revascularization techniques. 3 References 1. Byrne JG, Leacche M, Unic D, Rawn JD, Simon DI, Rogers CD, et al.Staged initial percutaneous coronary intervention followed by valve surgery ("hybrid approach") for patients with complex coronary and valve disease.
Treatment with statins lowers plasma nitrite and CRP levels in patients with PAD. Our data support the effects of statins in vivo that have been demonstrated on the endothelium ex vivo, suggesting a beneficial effect by acting on the initial processes that trigger the disease, reducing oxidative stress (increase in the bioavailability of nitric oxide as peroxynitrite levels decrease) and curtailing the inflammatory processes which perpetuate the disease.
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