Key result
Hybrid coronary revascularisation is safe and feasible in appropriately selected patients, though further large-scale randomised trials are needed to clarify its role versus standalone CABG or PCI.
Why the study?
Hybrid coronary revascularisation integrates CABG and PCI to avoid full sternotomy and cardiopulmonary bypass, but its techniques, strategies, and comparative role require clarification.
This review highlights hybrid coronary revascularisation as a safe and feasible strategy that combines the durability of LIMA-LAD bypass with the minimally invasive nature of PCI for selected patients with multivessel disease.
HCR may suit selected multivessel patients avoiding sternotomy; leaves open need for RCTs to guide adoption.
Hybrid coronary revascularisation (HCR) integrates coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) to combine the benefits of minimally invasive surgery and advanced stent technology. Typically, HCR involves off-pump left internal mammary artery (LIMA) to left anterior descending artery (LAD) bypass via minimally invasive direct coronary artery bypass (MIDCAB), complemented by PCI to non-LAD vessels. This approach avoids a full sternotomy and cardiopulmonary bypass while preserving the advantages of surgical revascularisation. Patient selection for HCR should be guided by a multidisciplinary heart team, targeting those with severe LAD disease and suitable non-LAD lesions for PCI. This review outlines the surgical techniques, anticoagulation strategies, and procedural sequencing employed in HCR, along with real-world outcomes from observational studies and randomised trials. While current evidence supports the safety and feasibility of HCR in appropriately selected patients, further large-scale randomised trials are needed to clarify its role in comparison to standalone CABG or PCI.
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Fazmin et al. (2025) conducted a review in Coronary artery disease. Hybrid coronary revascularisation (HCR) vs. Standalone CABG or PCI was evaluated. Hybrid coronary revascularisation is safe and feasible in appropriately selected patients, though further large-scale randomised trials are needed to clarify its role versus standalone CABG or PCI.
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