Status Quo of Hybrid Coronary Revascularization for Multi-Vessel Coronary Artery Disease

Harskamp, Ralf E.; Zheng, Zhe; Alexander, John H.; Williams, Judson B.; Xian, Ying; Halkos, Michael E.; Brennan, J. Matthew; Winter, Robbert J. de; Smith, Peter K.; Lópes, Renato D.

doi:10.1016/j.athoracsur.2013.07.093

Cited by 45 publications

(47 citation statements)

References 64 publications

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“…However, the use of MINI-CAB could regain popularity, because recent studies of “hybrid coronary revascularization” (in which MINI-CAB is combined with DESs for non-LAD lesions) have shown promising results compared with conventional surgery. 28 …”

Section: Discussionmentioning

confidence: 99%

Meta-analysis of minimally invasive coronary artery bypass versus drug-eluting stents for isolated left anterior descending coronary artery disease

Harskamp

Williams

Halkos

et al. 2014

The Journal of Thoracic and Cardiovascular Surgery

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Objective To compare the outcomes between minimally invasive coronary artery bypass (MINI-CAB) and drug-eluting stent (DES) implantation for isolated left anterior descending artery disease. Methods Randomized and observational comparative publications were identified using MEDLINE and Google Scholar databases (January 2003 to December 2013). Studies without outcomes data, without DES use, or using conventional bypass surgery were excluded. The outcomes of interest were cardiac death, myocardial infarction, target vessel revascularization, and periprocedural stroke. Data were compared using the Mantel-Haenszel methods and are presented as odds ratios (ORs), 95%confidence intervals (CIs), and number needed to treat. Results From 230 publications, we identified 4 studies (2 randomized and 2 observational) with 941 patients (478 had undergone MINI-CAB and 463 DES implantation). The incidence of target vessel revascularization at maximum follow-up (range, 6–60 months) was significantly lower in the MINI-CAB group (OR, 0.16; 95%CI, 0.08–0.30; P < .0001; number needed to treat, 13). The incidence of cardiac mortality and MI was similar between the MINI-CAB and DES groups during follow-up (OR, 1.05; 95% CI, 0.44–2.47; and OR, 0.83; 95% CI, 0.43–1.58, respectively). In addition, a similar incidence of periprocedural death (OR, 0.85; 95% CI, 0.21–3.47; P = .82), myocardial infarction (OR, 0.98; 95% CI, 0.38–2.58; P = .97), and stroke (OR, 1.36; 95% CI, 0.28–6.70; P = .70) was observed between the 2 treatment modalities. Conclusions Given the available evidence, MINI-CAB will result in lower target vessel revascularization rates but otherwise similar clinical outcomes compared with DESs in patients with left anterior descending artery disease.

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Section: Discussionmentioning

confidence: 99%

Meta-analysis of minimally invasive coronary artery bypass versus drug-eluting stents for isolated left anterior descending coronary artery disease

Harskamp

Williams

Halkos

et al. 2014

The Journal of Thoracic and Cardiovascular Surgery

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“…Second, the use of drug-eluting stents appears to be inferior to the excellent long-term patency seen when the LIMA is grafted to the LAD coronary artery (LIMA-LAD), as suggested by the long-term outcomes of a randomized clinical trial [7] as well as data from a recent metaanalysis, which show lower rates of target vessel revascularization with an odds ratio (OR) of 0.16, 95% confidence interval (CI): 018-0.30, P < 0.001 [8]. Third, the use of an isolated LIMA-LAD graft allows the use of off-pump, minimally invasive surgical techniques, which may lower complication rates and shorten postprocedural recovery compared with conventional surgical techniques [9][10][11][12].…”

Section: The 'Best Of Both Worlds' Approachmentioning

confidence: 94%

Current state and future direction of hybrid coronary revascularization

Harskamp¹

2015

Current Opinion in Cardiology

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“…The 2-staged procedure is defined as PCI and CABG performed in 2 different operative suites; the 2 procedures are separated by hours, days, or weeks, whereas the 1-stop refers to hybrid CABG/PCI performed in a hybrid suite in 1 setting, within minutes. Initially, the 1-stop HCR was considered to be a safe and feasible option with more acceptable mid-term clinical outcomes than CABG and PCI in selected patients with multivessel CAD [7–10]. However, few studies on the mid-term or long-term outcomes of the 2-staged procedure as compared to the OPCAB strategy are available.…”

Section: Introductionmentioning

confidence: 99%

Mid-term follow-up outcomes of 2-staged hybrid coronary revascularization compared with off-pump coronary artery bypass for patients with multivessel coronary artery disease.

Song

Ling

et al. 2017

Videosurgery and Other Miniinvasive Techniques

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IntroductionTwo-staged hybrid coronary revascularization (HCR) is a novel procedure in selected patients with multivessel coronary artery disease. However, few studies are available on the mid-term or long-term outcomes of this 2-staged procedure as compared to off-pump coronary artery bypass (OPCAB).AimTo compare in-hospital and mid-term follow-up outcomes of 2-staged HCR with OPCAB in patients with multivessel coronary artery disease.Material and methodsThe present retrospective study analyzed the data from 73 patients who underwent the 2-staged HCR (HCR group) during 2012–2014 at the heart center. Three hundred and eighty-three patients who underwent conventional OPCAB by the same surgeon were selected for the comparative analysis performed on in-hospital and mid-term follow-up outcomes between the two groups.ResultsNo significant difference was observed in the preoperative outcome between the two groups. The HCR group had a shorter operation duration (152.9 ±43.8 vs. 262.6 ±51.8 min, p < 0.05), less bleeding (558.6 ±441.3 vs. 1035.5 ±613.3 ml, p < 0.05), shorter mechanical ventilation (9.4 ±7.4 vs. 19.0 ±18.3 h, p < 0.05), and less blood transfusion (12 (16.4%) vs. 200 (52.2%), p < 0.05). The mean follow-up duration was 25.0 ±9.6 months in the HCR group and 22.8 ±10.6 months in the OPCAB group. The incidence of major adverse cardiac or cerebrovascular events (MACCE) was similar in both groups (4 (5.5%) vs. 10 (2.8%), p = 0.408). The estimated 3-year survival was similar in both groups (log-rank χ2 = 1.041, p = 0.308).ConclusionsThe 2-staged HCR is a safe and effective surgical procedure and may offer similar mid-term follow-up outcomes to OPCAB.

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Status Quo of Hybrid Coronary Revascularization for Multi-Vessel Coronary Artery Disease

Cited by 45 publications

References 64 publications

Meta-analysis of minimally invasive coronary artery bypass versus drug-eluting stents for isolated left anterior descending coronary artery disease

Meta-analysis of minimally invasive coronary artery bypass versus drug-eluting stents for isolated left anterior descending coronary artery disease

Current state and future direction of hybrid coronary revascularization

Mid-term follow-up outcomes of 2-staged hybrid coronary revascularization compared with off-pump coronary artery bypass for patients with multivessel coronary artery disease.

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