Status quo of hybrid coronary revascularization for multi-vessel coronary artery disease

Ralf E Harskamp, Zhe Zheng, John H Alexander, Judson B Williams, Ying Xian, Michael E Halkos, J Matthew Brennan, Robbert J de Winter, Peter K Smith, Renato D Lopes, Ralf E Harskamp, Zhe Zheng, John H Alexander, Judson B Williams, Ying Xian, Michael E Halkos, J Matthew Brennan, Robbert J de Winter, Peter K Smith, Renato D Lopes

Abstract

Hybrid coronary revascularization (HCR) combines bypass grafting of the left anterior descending (LAD) coronary artery with percutaneous coronary intervention (PCI) of non-LAD vessels. HCR has been performed as an alternative to CABG or multi-vessel PCI in thousands of patients since the late 1990s. In this review article, we provide an overview on patient selection, procedural sequence and timing, use of surgical techniques and anti-platelet agents. Additionally, patient recovery, satisfaction, costs and clinical outcomes of individual studies after HCR are evaluated. Future directions are also discussed, including the need for adequately powered randomized trials.

Figures

Fig 1
Fig 1
Rates of vein graft failure with 1-year angiography and restenosis and stent thrombosis rates in drug-eluting stents [–12, 66].
Fig 2
Fig 2
In-hospital cost-specific data of the average patient after 1-stage hybrid coronary revascularization (HCR) versus complete revascularization with off-pump coronary artery bypass graft surgery (OPCAB).

Source: PubMed

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