Current trends in hybrid coronary revascularization

Hybrid coronary revascularization (HCR) is a combined approach for multivessel coronary artery disease (MVD), integrating surgical grafting of the left internal mammary artery (LIMA) to the left anterior descending artery (LAD) with percutaneous coronary intervention (PCI) for non-LAD lesions. It aims to reduce invasiveness while maintaining effectiveness.

To summarize current evidence on the safety, effectiveness, and clinical outcomes of HCR compared to coronary artery bypass grafting (CABG), PCI, and off-pump coronary artery bypass (OPCAB).

A review of current literature including clinical trials, meta-analyses, and observational studies was conducted. Focus was placed on procedural techniques, patient selection, and outcomes.

HCR is associated with shorter hospital stays, reduced bleeding, and faster recovery compared to CABG. Compared to PCI, it shows improved LAD patency and fewer repeat interventions. Outcomes are similar to OPCAB, with lower myocardial injury. Despite its benefits, HCR remains underused due to technical demands and limited availability of hybrid facilities.

Further randomized trials are needed to confirm its long-term safety, effectiveness, and cost-efficiency.