Related Experiment Video
Updated: Feb 12, 2026
Author Spotlight: Enhancing Coronary Artery Revascularization
Published on: September 15, 2023
Hybrid Coronary Revascularization Versus On-Pump Coronary Artery Bypass Grafting
Vincenzo Giambruno1, Philip Jones2, Feras Khaliel1
1Division of Cardiac Surgery, Department of Surgery, Western University, London Health Sciences Centre, London, Ontario, Canada.
Insights
Hybrid coronary revascularization (HCR) offers a faster recovery and similar long-term results compared to traditional coronary artery bypass grafting (CABG) for multivessel coronary artery disease.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Cardiac Procedures
- Interventional Cardiology
Background:
- Hybrid coronary revascularization (HCR) is an emerging strategy for treating multivessel coronary artery disease.
- This study compares HCR with conventional on-pump coronary artery bypass graft surgery (CABG).
Purpose of the Study:
- To compare the short-term and long-term outcomes of HCR versus on-pump CABG.
- To evaluate the efficacy and safety of HCR in selected patients.
Main Methods:
- Comparative analysis of 682 on-pump CABG patients and 147 HCR patients (robotic-assisted minimally invasive bypass grafts plus percutaneous coronary intervention).
- Propensity score matching and inverse-probability weighting were used for adjusted analysis.
- Long-term follow-up was conducted for survival and revascularization rates.
Main Results:
- HCR showed lower in-hospital mortality (0% vs 1.3%) and shorter hospital stay (4.5 vs 6.7 days).
- No significant differences in reexploration for bleeding, perioperative MI, stroke, dialysis, transfusion, ventilation, or ICU stay.
- Long-term survival and freedom from revascularization were similar; HCR demonstrated superior freedom from angina (91% vs 70%).
Conclusions:
- HCR is a viable option for selected patients with multivessel coronary artery disease.
- HCR is associated with faster postoperative recovery and comparable short- and long-term outcomes to on-pump CABG.
- HCR demonstrates improved angina relief compared to CABG.
Background:
Hybrid coronary revascularization (HCR) is an evolving coronary revascularization strategy for the treatment of multivessel coronary artery disease. We provide a comparative analysis to conventional on-pump coronary artery bypass graft surgery (CABG) with long-term follow-up.
Methods:
We included all double on-pump CABG (n = 682) and HCR (147 robotic-assisted minimally invasive bypass grafts of the left internal thoracic artery to the left anterior descending coronary artery and percutaneous coronary intervention to one of the non-left anterior descending coronary artery vessels) performed in our institution between March 2004 and November 2015. We performed an adjusted analysis using inverse-probability weighting based on the propensity score of receiving either on-pump CABG or HCR.
Results:
In the adjusted analysis, there was no statistically significant difference in the incidence of reexploration for bleeding, perioperative myocardial infarction, stroke, need for hemodialysis, blood transfusion rate, prolonged mechanical ventilation, and intensive care unit length of stay. Hybrid coronary revascularization was associated with lower inhospital mortality (CABG 1.3%, HCR 0%, p = 0.008), and shorter mean (± SD) hospital length of stay (CABG 6.7 ± 4.7 days, HCR 4.5 ± 2.1 days, p < 0.001). After a median follow-up period of 70 months (range, 37 to 106) for the CABG group and 96 months (range, 53 to 114) for the HCR group, there was no significant difference in survival (CABG 92%, HCR 97%, p = 0.13) or freedom from any form of revascularization (CABG 93%, HCR 91%, p = 0.27). Hybrid coronary revascularization was superior in freedom from angina (CABG 70%, HCR 91%, p < 0.001).
Conclusions:
For selected patients, HCR is associated with a faster postoperative recovery as well as similar short-term and long-term outcomes when compared with standard on-pump CABG.
More Related Videos
09:12Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
Published on: March 27, 2018
12:00Evaluation of a Novel Laser-assisted Coronary Anastomotic Connector - the Trinity Clip - in a Porcine Off-pump Bypass Model
Published on: November 24, 2014
Related Concept Videos
01:30Coronary Artery Disease I: Introduction
01:26Coronary Artery Disease II: Pathophysiology
01:27Coronary Artery Disease V: Interprofessional Care
01:30Coronary Artery Disease III: Clinical Manifestations
01:26Coronary Artery Disease IV: Preventive Measures
01:21Coronary Circulation
Coronary circulation begins at the base of the aorta, where two main arteries arise—the left and right coronary arteries. These arteries encircle the heart in the coronary sulcus and supply the...