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Dixon LK, Akberali U, Di Tommaso E, George S, Johnson T, Bruno VD. Hybrid coronary revascularization versus coronary artery bypass grafting for multivessel coronary artery disease: A systematic review and meta-analysis. Int J Cardiol 2022; 359:20-27. [DOI: 10.1016/j.ijcard.2022.04.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/23/2022] [Accepted: 04/10/2022] [Indexed: 01/07/2023]
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Nenna A, Nappi F, Spadaccio C, Greco SM, Pilato M, Stilo F, Montelione N, Catanese V, Lusini M, Spinelli F, Chello M. Hybrid coronary revascularization in multivessel coronary artery disease: a systematic review. Future Cardiol 2022; 18:219-234. [PMID: 35006006 DOI: 10.2217/fca-2020-0244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: Hybrid coronary revascularization (HCR) for multivessel coronary artery disease (CAD) integrates coronary artery bypass grafting (CABG) and percutaneous intervention in a planned revascularization strategy. This systematic review summarizes the state of this art of this technique. Methods: Major databases searched until October 2021. Results: The available literature on HCR includes three randomized trials, ten meta-analysis and 27 retrospective studies. The greatest benefits are observed in patients with low-to-intermediate risk and less complex coronary anatomy; highly complex disease and the presence of risk factors favored conventional CABG in terms of adverse events and survival. Conclusion: HCR is an interesting approach for multivessel CAD but should not be considered a 'one-size-fits-all' procedure. Further studies will specify the subset of patients likely to benefit most from this hybrid approach.
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Affiliation(s)
- Antonio Nenna
- Cardiovascular surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, Rome 00128, Italy
| | - Francesco Nappi
- Cardiac surgery, Centre Cardiologique du Nord, Rue des Moulins Gémeaux 32, Saint Denis 93200, Paris, France
| | - Cristiano Spadaccio
- Cardiac surgery, Golden Jubilee National Hospital, Agamemnon St, Clydebank G814DY, Glasgow, United Kingdom
| | - Salvatore Matteo Greco
- Cardiovascular surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, Rome 00128, Italy.,Cardiac surgery, ISMETT-IRCCS, Via Ernesto Tricomi 5, Palermo 90127, Italy
| | - Michele Pilato
- Cardiac surgery, ISMETT-IRCCS, Via Ernesto Tricomi 5, Palermo 90127, Italy
| | - Francesco Stilo
- Cardiovascular surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, Rome 00128, Italy
| | - Nunzio Montelione
- Cardiovascular surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, Rome 00128, Italy
| | - Vincenzo Catanese
- Cardiovascular surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, Rome 00128, Italy
| | - Mario Lusini
- Cardiovascular surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, Rome 00128, Italy
| | - Francesco Spinelli
- Cardiovascular surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, Rome 00128, Italy
| | - Massimo Chello
- Cardiovascular surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, Rome 00128, Italy
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Abstract
PURPOSE OF REVIEW With advances in minimally invasive surgical and percutaneous coronary therapies, hybrid coronary revascularization (HCR) is well positioned to be an ideal strategy for revascularization in selected patients with multivessel coronary artery disease (CAD). The purpose of this review is to highlight recent outcomes and comparative effectiveness studies of HCR. RECENT FINDINGS Patients undergoing HCR have comparable outcomes compared with coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI). The major benefits compared with CABG appear to be related to short-term morbidity and resource utilization. Compared with PCI, HCR may decrease repeat revascularization rates by decreasing reintervention of the left anterior descending coronary artery. SUMMARY Although HCR is associated with a significant learning curve, specifically with minimally invasive CABG techniques, the early outcomes remain promising and should be considered as a viable option for revascularization in select patients with multivessel CAD.
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