Hybrid Coronary Revascularization The Best of 2 Worlds? ∗

As early as 1997, Michael Mack’s essay discussed the outlook for the possibility of hybrid revascularization with the emergence of minimally invasive coronary surgery combining the off-pump and minimally invasive direct coronary artery bypass (MIDCAB) techniques with percutaneous coronary intervention (PCI) to a non-left anterior descending (LAD) artery target (1). Since that time, coronary surgery and PCI technology have evolved even more. Off-pump coronary artery bypass surgery and MIDCAB surgery have been established in clinical practice and, with the development of drug-eluting stents, a new era of PCI was born. Despite significantly improved short- and long-term results, the perfect revascularization for each individual patient has not yet been discovered. Surgery is still invasive. There are risks of stroke and bypass occlusions, stent-site restenosis, and acute stent thrombosis, and myocardial infarction has not yet been banished. The data from the SYNTAX (Synergy Between PCI With Taxus and Cardiac Surgery) trial illustrate the importance of anatomy and morphology in coronary artery disease (2). Conceivably, the good results of both therapeutic approaches could be combined. So, why not use a hybrid therapy more frequently?
Source: Journal of the American College of Cardiology - Category: Cardiology Source Type: research