Hybrid Procedures, Do They Have a Role?

A hybrid strategy is a combination of catheter-based therapy and traditional surgical intervention. This concept of combining the tools available only in the catheterization laboratory with the tools available only to the surgeon in order to minimize surgical morbidity has evolved since its implementation in the 1990s.1 Over the past decade, with advancement in stent technology and refinement of minimally invasive surgical approaches, a hybrid strategy has become an attractive alternative to standard surgical or catheter-based techniques. The indications, patient selection, and standardization of these procedures are still under way. Currently, there are no randomized clinical trials on hybrid procedures, and the clinical practice is based on single institutional experiences. The National Heart, Lung, and Blood Institute has just launched the first observational trial on hybrid coronary intervention to define the population eligible for hybrid coronary revascularization (HCR). Until more data become available, the hybrid strategy depends on close collaboration between the surgeon and the cardiologist at single institutions and should be tailored to individual patient needs.