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Hybrid coronary revascularization in multivessel coronary artery disease: a systematic review

Antonio Nenna1, Francesco Nappi2, Cristiano Spadaccio3

  • 1Cardiovascular Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, Rome, 00128, Italy.

Future Cardiology
|January 10, 2022
PubMed

Insights

Hybrid coronary revascularization (HCR) offers benefits for multivessel coronary artery disease (CAD) in select patients. However, conventional coronary artery bypass grafting (CABG) remains superior for high-risk individuals with complex disease.

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Clinical Outcomes Research

Background:

  • Multivessel coronary artery disease (CAD) requires effective revascularization strategies.
  • Hybrid coronary revascularization (HCR) combines surgical (CABG) and percutaneous (PCI) approaches.
  • The optimal role of HCR in CAD management is under investigation.

Purpose of the Study:

  • To systematically review the current evidence on hybrid coronary revascularization (HCR).
  • To summarize the state-of-the-art of HCR for multivessel coronary artery disease (CAD).

Main Methods:

  • Systematic literature search of major databases up to October 2021.
  • Inclusion of randomized trials, meta-analyses, and retrospective studies.
  • Synthesis of available data on HCR outcomes.

Main Results:

  • Evidence includes 3 randomized trials, 10 meta-analyses, and 27 retrospective studies.
  • HCR shows greatest benefit in low-to-intermediate risk patients with less complex coronary anatomy.
  • Conventional CABG is favored for highly complex disease and high-risk patients regarding adverse events and survival.

Conclusions:

  • HCR is a viable approach for specific multivessel CAD patient subsets.
  • HCR is not a universal solution and patient selection is crucial.
  • Further research is needed to define optimal patient candidates for HCR.

Keywords:
coronary artery bypass graftinghybrid coronary revascularizationmyocardial revascularizationpercutaneous coronary interventionsystematic review

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