Hybrid Revascularization Approach in a Patient With Cancer Metastatic to the Sternum

Hybrid revascularization is a less invasive approach to conventional open-chest coronary artery bypass graft surgery for patients with multivessel coronary arterial disease. However, this is infrequently performed because of technical demands, logistical challenges, and concerns for long-term vessel patency. A 68-year-old man with a history of prostate cancer with bony metastasis presented with accelerated angina. Left heart catheterization revealed multivessel coronary disease. The patient underwent staged hybrid surgical and percutaneous revascularization treatment. Ultimately, the intervention was successful, and the patient had symptomatic relief with successful recovery to baseline function. This case provides insight into the efficacy and application of an individualized hybrid approach in a high-risk patient with comorbidities. Hybrid revascularization is safe and can be considered on an individual basis for patients with complex medical comorbidities.