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by Mercedes K.C. Dullum, M.D.
Hybrid Revascularization
Hybrid coronary artery revascularization combines grafting the Left Internal Thoracic Artery (LITA) to the left anterior descending artery (LAD) with percutaneous coronary intervention (PCI) of the remaining diseased coronary arteries. The LAD anastamosis is performed through a minimally invasive approach either directly or with Robotic assistance. This approach retains the benefit of an internal thoracic artery bypass to the LAD and may provide a maximally beneficial outcome for many patients particularly those in the high risk category. With the improvements in medical management such as cholesterol lowering drugs, and stent technology, the benefits of this approach, should be available as an alternative to conventional coronary artery bypass surgery. Preliminary outcomes of patients receiving the hybrid approach have been favourable. Hybrid revascularization has been performed for many years since the resurgence of the MIDCAB and should be tailored for the individual patient. Patient selection, results, and evolution of this procedure needs to be evaluated.
Guest Commentaries
Dr. Howard Bush: Combination of minimally invasive coronary bypass and percutaneous coronary intervention in patients with multi-vessel coronary artery disease: a cardiologist’s perspective
Dr. Rafael Cabrales: Combination of minimally invasive coronary bypass and percutaneous coronary intervention in patients with multivessel disease: a Cardiothoracic Anesthesiologist’s Perspective
Dr. Johannes Bonatti and Dr. Guy Friedrich: Hybrid Coronary Artery Revascularization - Time to Reactivate the Concept?
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