Page 258 - Read Online

Gacad et al. Vessel Plus 2019;3:28 Vessel Plus
DOI: 10.20517/2574-1209.2019.011

Review Open Access

Respite for hybrid coronary revascularization

Vincent Gacad, Twinkle Singh, Ayush Motwani, Rohan Samson, Thierry H. Le Jemtel

Section of Cardiology, Department of Medicine, Tulane University School of Medicine, Tulane University Heart and Vascular
Institute, New Orleans, LA 70112, USA.

Correspondence to: Dr. Thierry H. Le Jemtel, Section of Cardiology, Department of Medicine, Tulane University School of
Medicine, Tulane University Heart and Vascular Institute, New Orleans, LA 70112, USA. E-mail: lejemtel@tulane.edu

How to cite this article: Gacad V, Singh T, Motwani A, Samson R, Le Jemtel TH. Respite for hybrid coronary revascularization.
Vessel Plus 2019;3:28. http://dx.doi.org/10.20517/2574-1209.2019.011

Received: 17 Apr 2019 First Decision: 26 Jun 2019 Revised: 15 Jul 2019 Accepted: 30 Jul 2019 Published: 7 Aug 2019

Science Editor: Mario F. L. Gaudino Copy Editor: Cai-Hong Wang Production Editor: Tian Zhang

Abstract
Hybrid coronary revascularization incorporates a surgical anastomosis of the left internal mammary artery to the left
anterior descending coronary artery through a thoracotomy and percutaneous implantation of drug eluting stents in
diseased non-left anterior descending coronary arteries. Hybrid coronary artery revascularization can be performed
as a 1-stage procedure in a hybrid operating room or as a tightly scheduled 2-stage procedure. Hybrid coronary artery
revascularization is seldom the selected modality for coronary revascularization due to the lack of a hybrid operating room
in many hospitals, the recommended thoracotomy approach for bypass, or the rigid schedule of surgical and endovascular
revascularization. A 2-stage approach, using a sternotomy as compared to standard thoracotomy, and a flexible schedule
between surgical and endovascular procedures may facilitate the adoption of hybrid coronary revascularization with non-
complex multi-vessel stable coronary artery disease.

Keywords: Hybrid, coronary artery bypass, revascularization, multi-vessel, saphenous vein graft, left anterior mammary artery,
percutaneous coronary intervention

INTRODUCTION
Medical therapy aiming at the stabilization and possibly the reversal of atherosclerosis in patients with
[1-4]
stable coronary artery disease (CAD) has steadily progressed over the past 20 years . However, patients
with CAD who remain symptomatic despite optimal anti-anginal therapy or with limited life expectancy
[5,6]
due to multi-vessel CAD (mCAD) are candidates for coronary artery revascularization (CAR) . CAR no
longer requires open heart surgery for the implantation of a coronary artery bypass graft (CABG); it

© The Author(s) 2019. 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.

www.vpjournal.net