Hybrid Coronary Revascularization - Current State of the Art

Hybrid coronary revascularization (HCR) seeks to combine the benefit of surgical and nonsurgical techniques for optimum management for selective patients with multivessel obstructive coronary artery disease. The goal of HCR is to combine the benefit of surgical anastomosis of the left internal mammary artery to the left anterior descending coronary artery (LAD) graft along with stenting of non-LAD lesions with percutaneous coronary intervention (PCI). HCR usually involves the use of minimally invasive surgical techniques like robotically assisted coronary artery bypass graft (CABG), with the objective to produce a rapid recovery in the postoperative period, lower complications, and decreased length of stay in the hospital. In this review the authors seek to define the role of HCR in current practice including patient selection, techniques, logistics, outcome data and the challenges it faces in comparison to conventional CABG and PCI.