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The Hybrid Approach to Coronary Artery Revascularization: Minimally Invasive Direct Coronary Artery Bypass with Percutaneous Coronary Intervention

State University of New York at Buffalo School of Medicine and Biomedical Sciences

Harry W. Donias

Department of Surgery, State University of New York at Buffalo

Guiseppe D'Ancona

Center for Less Invasive Cardiac Surgery and Robotic Surgery at Kaleida health at Buffalo General Hospital

Eddie L. Hoover

Department of Surgery, State University of New York at Buffalo, Division of Cardiothoracic Surgery, Kaleida health at Buffalo General Hospital

Hratch L. Karamanoukian

Division of Cardiothoracic Surgery, Kaleida health at Buffalo General Hospital, Center for Less Invasive Cardiac Surgery and Robotic Surgery at Kaleida health at Buffalo General Hospital

In the past decade, new developments in cardiology and cardiac surgery have begun to offer patients a variety of new, less invasive options for the treatment of coronary artery disease. One such option is the hybrid approach to coronary artery revascularization. This combines minimally invasive direct coronary artery bypass surgery (MIDCAB) of the left anterior descending artery (LAD) with percutaneous coronary intervention (PCI) of the remaining diseased coronary arteries. This approach, as an alternative to conventional coronary artery bypass surgery, retains the benefit of internal mammary artery bypass to the LAD, accom plished with a minimally invasive technique, substitutes PCI for saphenous vein grafts as treatment for low-grade lesions of other coronary arteries, and may provide a maximally bene ficial outcome for many patients. Preliminary outcomes of patients receiving the hybrid approach have been strikingly positive. This report highlights the rationale for the development of this procedure, patient selection, results, and future applications of this emerging method of treating coronary artery disease.

Angiology, Vol. 53, No. 6, 665-669 (2002)
DOI: 10.1177/000331970205300606


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