Practice Patterns and Clinical Outcomes After Hybrid Coronary Revascularization in the United States

Harskamp, Ralf E.; Brennan, J. Matthew; Xian, Ying; Halkos, Michael E.; Puskas, John D.; Thourani, Vinod H.; Gammie, James S.; Taylor, Bradley S.; Winter, Robbert J. de; Kim, Sunghee; O’Brien, Sean M.; Peterson, Eric D.; Gaca, Jeffrey G.

doi:10.1161/circulationaha.114.009479

Cited by 104 publications

(79 citation statements)

References 19 publications

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“…In general, it is best to treat the culprit lesion first; most commonly in clinical practice, the surgical component is completed first (24). When PCI is performed first, antiplatelet agents must be continued during surgery, which can be associated with higher chest tube output.…”

Section: Discussionmentioning

confidence: 99%

Hybrid coronary revascularization for the treatment of multivessel coronary artery disease

Kayatta

Halkos

Puskas³

2018

Ann. Cardiothorac. Surg.

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Coronary artery disease (CAD) has typically been treated either medically, with percutaneous coronary intervention (PCI), or with coronary artery bypass grafting (CABG). As advances in stent technology and minimally invasive surgery have developed, a third option has emerged: hybrid coronary revascularization (HCR). In HCR, minimally invasive CABG and PCI are both employed to treat a single patient, often during the same hospital stay. Patients appropriate for this technique vary widely, from low-risk patients with low SYNTAX lesions outside the left anterior descending artery (LAD), to high-risk patients with multiple comorbidities who are felt by the heart team to benefit most by avoiding a sternotomy. Across both our experience and other series in the literature, mortality with HCR is around 1%. Hospital length of stay is less than one week, and typically less than after conventional CABG, but longer than with isolated PCI. Return to baseline activity is substantially shorter after minimally invasive CABG compared to conventional CABG due to the avoidance of a sternotomy; deep sternal wound infections are entirely avoided. Mid-term need for repeat revascularization may be higher with HCR, though randomized data are lacking. In conclusion, HCR is an evolving method to treat multivessel CAD with favorable early results in high volume centers, though growth in the field is limited by surgical experience and success with minimally invasive techniques.

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Section: Discussionmentioning

confidence: 99%

Hybrid coronary revascularization for the treatment of multivessel coronary artery disease

Kayatta

Halkos

Puskas³

2018

Ann. Cardiothorac. Surg.

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“…Не угасает интерес к исследованиям различных стра-тегий прямой реваскуляризации миокарда в аспекте их преимущества у пациентов с СД [36,[45][46][47][48].…”

Section: различные стратегии прямой реваскуляризации миокарда у пациеunclassified

“…В течение 3-лет-него периода наблюдения гибридная реваскуляризация также не показала преимущества перед КШ в отношении смертности (р=0,86) [45].…”

Section: сахарный диабет Diabetes Mellitusunclassified

Myocardial revascularization in patients with coronary heart disease and type 2 diabetes

Безденежных

Sumin

2016

Diabetes mellitus

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The review discusses myocardial revascularization in patients with coronary heart disease and type 2 diabetes. The data presented include findings from recent research and international and national recommendations and provides evidence on the advantages of coronary artery bypass surgery over percutaneous coronary intervention for patients with diabetes mellitus, stable coronary artery disease and multiple coronary artery lesions. Type 2 diabetes remains a significant predictor of adverse long-term outcomes of coronary artery bypass surgery. Therefore, we review studies showing that different strategies of coronary revascularization and preoperative preparation can affect the results of coronary intervention in patients with diabetes.

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“…Hybrid revascularization acknowledges the relative benefit of an IMA for LAD revascularization, and the reduced invasiveness of PCI for non-LAD targets, in concert with the progressively improved results of PCI, particularly with later-generation drug-eluting stents. Although hybrid revascularization is commonly understood to involve a minimally invasive approach for left internal mammary artery (LIMA)-LAD bypass (MIDCAB, robotic), a full sternotomy for LIMA-LAD bypass in conjunction with PCI is compatible with the definition [56], and likely to be utilized by surgeons more often than one of the minimally invasive methods [57].…”

Section: Minimally Invasive Direct Coronary Artery Bypass and Hybrid mentioning

confidence: 99%

“…The European writing committee did make a strong recommendation to avoid aortic manipulation in patients with a very hostile ascending aorta, COR I, LOE B. The data supporting or refuting the MIDCAB and hybrid revascularization approaches are substantially more limited than for other procedural aspects of coronary bypass surgery [57].…”

Section: Minimally Invasive Direct Coronary Artery Bypass and Hybrid mentioning

confidence: 99%

Transatlantic editorial: A comparison between European and North American guidelines on myocardial revascularization

Kolh

Kurlansky

Cremer

et al. 2016

The Journal of Thoracic and Cardiovascular Surgery

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Practice Patterns and Clinical Outcomes After Hybrid Coronary Revascularization in the United States

Abstract: Background-Hybrid coronary revascularization (HCR) involves a combination of surgical and percutaneous techniques, which in selected patients may present an alternative to conventional coronary artery bypass grafting (CABG

Cited by 104 publications

References 19 publications

Hybrid coronary revascularization for the treatment of multivessel coronary artery disease

Hybrid coronary revascularization for the treatment of multivessel coronary artery disease

Myocardial revascularization in patients with coronary heart disease and type 2 diabetes

Transatlantic editorial: A comparison between European and North American guidelines on myocardial revascularization

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