Therapeutic Efficacy of a Staged Hybrid Technique vs. Coronary Artery Bypass Surgery Grafting in The Treatment of Multi-Vessel Coronary Artery Disease

Abstract

Objective: Hybrid coronary revascularization (HCR) integrates the advantages of coronary artery bypass surgery grafting (CABG) and percutaneous coronary intervention (PCI) and provides another effective treatment for multi-vessel coronary artery disease (CAD). This study aimed to investigate the short- and intermediate-term efficacies of a staged hybrid technique vs. CABG in treating older patients with multi-vessel CAD. Methods: Patients, who received elective revascularization for multi-vessel CAD between May 2016 and May 2018, were recruited. They were divided into the CABG group (N = 38) and HCR group (N = 38). The major adverse cardiovascular and cerebrovascular events (MACCE), including myocardial infarction and stroke, were recorded. The results of death and second revascularization also were recorded. Results: In this study, 90.1% of patients received follow up for a median time of 24 months. At 60 days after surgery, the cumulative mortality in the CABG group was significantly higher than in the HCR group, but the incidence of second revascularization in the CABG group was markedly lower than in the HCR group. The incidence of MACCE was comparable between the two groups. Conclusion: In older patients with multi-vessel CAD, the mortality after CABG is higher than after HCR, but the incidence of second revascularization after CABG is lower than after HCR.

Need for repeat revascularisation in hybrid coronary revascularisation vs. percutaneous coronary intervention

“…HCR is gaining popularity as an alternative to CABG and PCI in the treatment of the left main artery, providing a solution that integrates the advantages of both techniques while minimising surgical trauma and postoperative complications [ 4 , 10 ]. HCR is a safe procedure, providing promising midterm results, also in patients with high risk, and long-term in patients with multivessel coronary artery disease, especially in patients with proximal LAD stenosis [ 9 , 11 , 12 ]. The benefits of HCR are numerous; however, the decision to choose this treatment path over PCI must be made on an individual basis, taking into account factors such as lesion complexity and risk for the patient.…”