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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

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Hybrid coronary revascularization vs. percutaneous coronary interventions for multivessel coronary artery disease

Edward L Hannan1, Yi-Feng Wu1, Kimberly Cozzens1

  • 1University at Albany, State University of New York, Albany, NY, USA.

Journal of Geriatric Cardiology : JGC
|April 28, 2021
PubMed

Insights

Hybrid coronary revascularization (HCR) and percutaneous coronary intervention (PCI) showed similar long-term survival for multivessel disease. HCR reduced repeat revascularization in the left anterior descending artery, suggesting improved graft longevity.

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Health Services Research

Background:

  • Hybrid coronary revascularization (HCR) combines minimally invasive surgery for the left anterior descending (LAD) artery with percutaneous coronary intervention (PCI) for other coronary arteries.
  • While HCR offers shorter recovery than traditional bypass surgery, its long-term outcomes compared to isolated PCI for multivessel disease are less understood.

Purpose of the Study:

  • To compare the long-term efficacy of HCR versus PCI in patients with multivessel coronary artery disease.
  • To evaluate differences in mortality and repeat revascularization rates between HCR and PCI strategies.

Main Methods:

  • A cohort study utilizing data from New York's cardiac surgery and PCI registries (2010-2016).
  • Analysis included 335 HCR patients and 25,557 PCI patients with multivessel coronary artery disease.
  • Cox proportional hazards models were employed to adjust for selection bias, with a median follow-up of four years.

Main Results:

  • No significant difference in 6-year adjusted survival rates between HCR and PCI groups (83.17% vs. 81.65%).
  • HCR patients demonstrated a significantly lower rate of repeat revascularization in the LAD artery (91.13% vs. 83.59%).

Conclusions:

  • Hybrid coronary revascularization is infrequently utilized for multivessel coronary artery disease.
  • HCR is associated with comparable long-term mortality to PCI but offers reduced rates of repeat revascularization in the LAD artery.
  • The improved outcomes for HCR in the LAD artery may be attributed to the superior durability of left arterial mammary grafts.
Abstract

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