Hybrid coronary revascularization: present indications and future perspective.

Overview

Hybrid coronary revascularization (HCR) strategy consists of minimal invasive left internal mammary artery to left anterior descending bypass grafting and percutaneous coronary intervention (PCI) of the remaining lesions. HCR combines the known benefits of the LIMA-to-LAD graft (LIMA: left internal mammary artery, LAD: left anterior descending) and drug eluting stent (DES) to non-LAD regions and is currently reserved for particularly high-risk patients with favorable anatomy. Despite the lack of multicenter randomized trials, several small non-randomized studies have shown that HCR is safe with low mortality rates, low morbidity, and shorter intensive care unit and hospital stay. Up to date, HCR appears to be a promising and cost-effective alternative for CABG in the treatment of multivessel coronary artery disease in a selected patient population.