Role and Rationale for Hybrid Coronary Artery Revascularization

The optimal revascularization strategy for patients with multi-vessel coronary artery disease remains controversial. The advent of percutaneous coronary intervention (PCI) has challenged the superiority of coronary artery bypass graft (CABG) surgery for multi-vessel disease. In the late 1990s, an integrated approach, now referred to as “hybrid coronary revascularization” (HCR), was pioneered combining CABG and PCI to offer appropriate patients a less invasive option for revascularization while still capitalizing on the superior patency rates of the left internal mammary artery (LIMA) to the left anterior descending (LAD) artery bypass . The operative techniques continue to evolve as well as the timing strategies for intervention and use of antiplatelet therapy. While more research is needed, current data supports hybrid coronary revascularization as a promising technique to optimize outcomes in patients with multi-vessel coronary artery disease.