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Minimally Invasive Surgery
Volume 2013, Article ID 142616, 10 pages
Review Article

Hybrid Coronary Revascularization as a Safe, Feasible, and Viable Alternative to Conventional Coronary Artery Bypass Grafting: What Is the Current Evidence?

Department of Cardiothoracic Surgery, Maastricht University Medical Center, P. Debyelaan 25, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands

Received 10 August 2012; Accepted 13 March 2013

Academic Editor: Casey M. Calkins

Copyright © 2013 Arjan J. F. P. Verhaegh et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The “hybrid” approach to multivessel coronary artery disease combines surgical left internal thoracic artery (LITA) to left anterior descending coronary artery (LAD) bypass grafting and percutaneous coronary intervention of the remaining lesions. Ideally, the LITA to LAD bypass graft is performed in a minimally invasive fashion. This review aims to clarify the place of hybrid coronary revascularization (HCR) in the current therapeutic armamentarium against multivessel coronary artery disease. Eighteen studies including 970 patients were included for analysis. The postoperative LITA patency varied between 93.0% and 100.0%. The mean overall survival rate in hybrid treated patients was 98.1%. Hybrid treated patients showed statistically significant shorter hospital length of stay (LOS), intensive care unit (ICU) LOS, and intubation time, less packed red blood cell (PRBC) transfusion requirements, and lower in-hospital major adverse cardiac and cerebrovascular event (MACCE) rates compared with patients treated by on-pump and off-pump coronary artery bypass grafting (CABG). This resulted in a significant reduction in costs for hybrid treated patients in the postoperative period. In studies completed 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.