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Pusca et al. Mini-invasive Surg 2021;5:51 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2021.45

Review Open Access

Hybrid coronary revascularization: the Emory

experience

Sorin V. Pusca, Michael E. Halkos
Department of Surgery, Division of Cardiothoracic Surgery, Emory University, Atlanta, GA 30322, USA.

Correspondence to: Dr. Michael E. Halkos, Division of Cardiothoracic Surgery, Department of Surgery, Emory University, 1364
Clifton Road, Atlanta, GA 30322, USA. E-mail: mhalkos@emory.edu

How to cite this article: Pusca SV, Halkos ME. Hybrid coronary revascularization: the Emory experience. Mini-invasive Surg
2021;5:51. https://dx.doi.org/10.20517/2574-1225.2021.45

Received: 29 Mar 2021 First Decision: 7 Jun 2021 Revised: 28 Jun 2021 Accepted: 19 Jul 2021 First online: 5 Nov 2021

Academic Editor: Giulio Belli Copy Editor: Xi-Jun Chen Production Editor: Xi-Jun Chen

Abstract
This article reviews the Emory University Experience with hybrid coronary revascularization and identifies key
factors essential for the success of this relatively new and evolving strategy for the treatment of coronary artery
disease. Key decisional and technical factors were identified. In addition, careful patient selection, stepwise
progression in learning the different aspects of the procedure, and close collaboration between cardiac surgery-
interventional cardiology are key factors for success.

Keywords: Hybrid coronary revascularization, robotic coronary bypass, robotic LIMA LAD anastomosis

INTRODUCTION
Hybrid coronary revascularization (HCR) has evolved over the past decade as a strategy for the treatment of
multivessel coronary artery disease combining the most significant advantages of surgical coronary artery
bypass (CABG) and coronary artery stenting in order to provide the best possible short- and long-term
results with minimal invasion of the patient. The 88%-90% 20-year patency rate of left internal mammary
artery (LIMA) to left anterior descending (LAD) coronary artery is the pinnacle of what CABG can offer
[1-4]
and is hard to beat . This excellent patency rate translates into improved survival, improved relief of
[1-4]
symptoms, decrease in major adverse cardiac events and decrease the need for reintervention . Equally
important, even though CABG has better long term outcomes than percutaneous coronary intervention
[5]
(PCI)for multivessel CAD , the newer generation drug-eluting stents (DES) deployed to treat discrete

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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