Mid-term follow-up outcomes of 2-staged hybrid coronary revascularization compared with off-pump coronary artery bypass for patients with multivessel coronary artery disease

• Main Authors: Song Wu, Yunpeng Ling, Yuanhao Fu, Lufeng Zhang, Hang Yang, Lijun Guo, Wei Gao, Feng Wan
• Format: Article
• Language: English
• Published: Termedia Publishing House 2017-03-01
• Series: Videosurgery and Other Miniinvasive Techniques
• Subjects: <i>two-staged hybrid coronary revascularization; percutaneous coronary intervention; off-pump coronary artery bypass; minimally invasive direct coronary artery bypass graft surgery; follow-up outcomes</i>
• Online Access: https://www.termedia.pl/Mid-term-follow-up-outcomes-of-2-staged-hybrid-coronary-revascularization-compared-with-off-pump-coronary-artery-bypass-for-patients-with-multivessel-coronary-artery-disease,42,29696,1,1.html

Introduction : Two-staged hybrid coronary revascularization (HCR) is a novel procedure in selected patients with multivessel coronary artery disease. However, few studies are available on the mid-term or long-term outcomes of this 2-staged procedure as compared to off-pump coronary artery bypass (OPCAB). Aim: To compare in-hospital and mid-term follow-up outcomes of 2-staged HCR with OPCAB in patients with multivessel coronary artery disease. Material and methods: The present retrospective study analyzed the data from 73 patients who underwent the 2-staged HCR (HCR group) during 2012–2014 at the heart center. Three hundred and eighty-three patients who underwent conventional OPCAB by the same surgeon were selected for the comparative analysis performed on in-hospital and mid-term follow-up outcomes between the two groups. Results : No significant difference was observed in the preoperative outcome between the two groups. The HCR group had a shorter operation duration (152.9 ±43.8 vs. 262.6 ±51.8 min, p < 0.05), less bleeding (558.6 ±441.3 vs. 1035.5 ±613.3 ml, p < 0.05), shorter mechanical ventilation (9.4 ±7.4 vs. 19.0 ±18.3 h, p < 0.05), and less blood transfusion (12 (16.4%) vs. 200 (52.2%), p < 0.05). The mean follow-up duration was 25.0 ±9.6 months in the HCR group and 22.8 ±10.6 months in the OPCAB group. The incidence of major adverse cardiac or cerebrovascular events (MACCE) was similar in both groups (4 (5.5%) vs. 10 (2.8%), p = 0.408). The estimated 3-year survival was similar in both groups (log-rank χ 2 = 1.041, p = 0.308). Conclusions : The 2-staged HCR is a safe and effective surgical procedure and may offer similar mid-term follow-up outcomes to OPCAB.