[Hybrid myocardial revascularization in elderly and senile patients: Advantages and disadvantages.]

Hybrid coronary revascularization (HCR) is a strategy combining minimally invasive left internal mammary artery to left anterior descending artery bypass grafting with percutaneous coronary intervention of the remaining vessels. This approach is of particular relevance in elderly (60-74 years) and senile (≥75 years) patients due to high surgical risk and severe comorbidities. This review analyzes current evidence (2016-2025) on the efficacy and safety of HCR in this population. HCR provides long-term survival comparable to conventional coronary artery bypass grafting with lower perioperative trauma, shorter hospital stay, and reduced neurological complications. Key limitations include the need for dual antiplatelet therapy, higher mid-term repeat revascularization rates, technical complexity, and resource intensity. Decisions regarding HCR in elderly patients require thorough multidisciplinary assessment including frailty screening, functional status, and life expectancy evaluation.