Hybrid coronary revascularization <i>versus</i> off-pump coronary artery bypass grafting for treatment of multivessel coronary artery diseases_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

SHENG Wei ¹ , ZHAO Liyue ¹ , WANG Tianyi ¹ , NIU Zhaozhuo ¹ , ZHANG Wenfeng ¹ , WU Jiantao ¹ , LI Haoyou ¹ ,  YANG Haiqin ²

1. Department of Cardiovascular Surgery, Qingdao Municipal Hospital, Medical College of Qingdao University, Qingdao, 266071, Shandong, P.R.China;
2. Department of Mental Intervention, Qingdao Preferential Hospital, Qingdao, 266071, Shandong, P.R.China;

Corresponding author：

YANG Haiqin, Email: rose8118@126.com

Keywords：

Hybrid technique; coronary artery bypass grafting; minimally invasive; percutaneous coronary intervention; surgery

DOI：

10.7507/1007-4848.202008046

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Objective To investigate the feasibility and safety of hybrid coronary revascularization (HCR) in patients with multivessel coronary artery disease (MVCAD).Methods A total of 50 patients with MVCAD who underwent HCR technique in our heart center from May 2016 to April 2019 were included in this study (a HCR group), including 38 patients who underwent two-stage HCR and 12 patients one-stop HCR. There were 39 males and 11 females, with an average age of 62.4 (46-82) years. Another 482 patients who underwent conventional median incision under off-pump coronary artery bypass grafting (OPCAB) at the same period were selected as control (an OPCAB group), including 392 males and 90 females, with an average age of 64.2 (48-84) years. The safety and feasibility of HCR were evaluated and compared with conventional OPCAB technique.Results There was no perioperative death in both groups. Compared with the OPCAB, HCR was associated with shorter operation time, less chest tube drainage, lower requirement of blood transfusion, shorter mechanical ventilation time and shorter postoperative intensive care unit (ICU) stay (P<0.05). There was no statistical difference in the incidence of major adverse cardiac or cerebrovascular events during the follow-up of 6 to 36 months between the two groups.Conclusion HCR provides favorable short and mid-term outcomes for selected patients with MVCAD compared with conventional OPCAB.

Citation： SHENG Wei, ZHAO Liyue, WANG Tianyi, NIU Zhaozhuo, ZHANG Wenfeng, WU Jiantao, LI Haoyou, YANG Haiqin. Hybrid coronary revascularization versus off-pump coronary artery bypass grafting for treatment of multivessel coronary artery diseases. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(7): 801-805. doi: 10.7507/1007-4848.202008046 Copy

1.	沈刘忠, 宋之昭, 胡盛寿, 等. 一站式复合技术与非体外循环冠状动脉旁路移植术治疗合并糖尿病的多支冠状动脉病变的病例对照研究. 中国胸心血管外科临床杂志, 2017, 24(12): 916-922.
2.	Choi W, Chang HW, Kang SH, et al. Comparison of minimally invasive direct coronary artery bypass and percutaneous coronary intervention using second-generation drug-eluting stents for coronary artery disease — Propensity score-matched analysis. Circ J, 2019, 83(7): 1572-1580.
3.	Khan MR, Kayani WT, Ahmad W, et al. Meta-analysis of comparison of 5-year outcomes of percutaneous coronary intervention versus coronary artery bypass grafting in patients with unprotected left main coronary artery in the era of drug-eluting stents. Am J Cardiol, 2017, 120(9): 1514-1520.
4.	中国冠状动脉杂交血运重建专家共识(2017版)编写组. 中国冠状动脉杂交血运重建专家共识(2017版). 中华胸心血管外科杂志, 2017, 33(8): 449-455.
5.	Kim DW, Her SH, Park HW, et al. Incremental age-related one-year MACCE after acute myocardial infarction in the drug-eluting stent era (from KAMIR-NIH registry). J Geriatr Cardiol, 2018, 15(9): 574-584.
6.	Fitzgibbon GM, Kafka HP, Leach AJ, et al. Coronary bypass graft fate and patient outcome: Angiographic follow-up of 5, 065 grafts related to survival and reoperation in 1, 388 patients during 25 years. J Am Coll Cardiol, 1996, 28(3): 616-626.
7.	Hannan EL, Zhong Y, Walford G, et al. Coronary artery bypass graft surgery versus drug-eluting stents for patients with isolated proximal left anterior descending disease. J Am Coll Cardiol, 2014, 64(25): 2717-2726.
8.	Merkle J, Zeriouh M, Sabashnikov A, et al. Minimally invasive direct coronary artery bypass graft surgery versus percutaneous coronary intervention of the LAD: Costs and long-term outcome. Perfusion, 2019, 34(4): 323-329.
9.	Goldman S, Zadina K, Moritz T, et al. Long-term patency of saphenous vein and left internal mammary artery grafts after coronary artery bypass surgery: Results from a Department of Veterans Affairs Cooperative Study. J Am Coll Cardiol, 2004, 44(11): 2149-2156.
10.	Ruttmann E, Dietl M, Feuchtner GM, et al. Long-term clinical outcome and graft patency of radial artery and saphenous vein grafts in multiple arterial revascularization. J Thorac Cardiovasc Surg, 2019, 158(2): 442-450.
11.	Fanari Z, Weiss SA, Zhang W, et al. Comparison of percutaneous coronary intervention with drug eluting stents versus coronary artery bypass grafting in patients with multivessel coronary artery disease: Meta-analysis of six randomized controlled trials. Cardiovasc Revasc Med, 2015, 16(2): 70-77.
12.	Papadopoulos K, Lekakis I, Nicolaides E. Outcomes of coronary artery bypass grafting versus percutaneous coronary intervention with second-generation drug-eluting stents for patients with multivessel and unprotected left main coronary artery disease. SAGE Open Med, 2017, 5: 2050312116687707.
13.	Hu S, Li Q, Gao P, et al. Simultaneous hybrid revascularization versus off-pump coronary artery bypass for multivessel coronary artery disease. Ann Thorac Surg, 2011, 91(2): 432-438.
14.	Kayatta MO, Halkos ME, Puskas JD. Hybrid coronary revascularization for the treatment of multivessel coronary artery disease. Ann Cardiothorac Surg, 2018, 7(4): 500-505.

1. 沈刘忠, 宋之昭, 胡盛寿, 等. 一站式复合技术与非体外循环冠状动脉旁路移植术治疗合并糖尿病的多支冠状动脉病变的病例对照研究. 中国胸心血管外科临床杂志, 2017, 24(12): 916-922.
2. Choi W, Chang HW, Kang SH, et al. Comparison of minimally invasive direct coronary artery bypass and percutaneous coronary intervention using second-generation drug-eluting stents for coronary artery disease — Propensity score-matched analysis. Circ J, 2019, 83(7): 1572-1580.
3. Khan MR, Kayani WT, Ahmad W, et al. Meta-analysis of comparison of 5-year outcomes of percutaneous coronary intervention versus coronary artery bypass grafting in patients with unprotected left main coronary artery in the era of drug-eluting stents. Am J Cardiol, 2017, 120(9): 1514-1520.
4. 中国冠状动脉杂交血运重建专家共识(2017版)编写组. 中国冠状动脉杂交血运重建专家共识(2017版). 中华胸心血管外科杂志, 2017, 33(8): 449-455.
5. Kim DW, Her SH, Park HW, et al. Incremental age-related one-year MACCE after acute myocardial infarction in the drug-eluting stent era (from KAMIR-NIH registry). J Geriatr Cardiol, 2018, 15(9): 574-584.
6. Fitzgibbon GM, Kafka HP, Leach AJ, et al. Coronary bypass graft fate and patient outcome: Angiographic follow-up of 5, 065 grafts related to survival and reoperation in 1, 388 patients during 25 years. J Am Coll Cardiol, 1996, 28(3): 616-626.
7. Hannan EL, Zhong Y, Walford G, et al. Coronary artery bypass graft surgery versus drug-eluting stents for patients with isolated proximal left anterior descending disease. J Am Coll Cardiol, 2014, 64(25): 2717-2726.
8. Merkle J, Zeriouh M, Sabashnikov A, et al. Minimally invasive direct coronary artery bypass graft surgery versus percutaneous coronary intervention of the LAD: Costs and long-term outcome. Perfusion, 2019, 34(4): 323-329.
9. Goldman S, Zadina K, Moritz T, et al. Long-term patency of saphenous vein and left internal mammary artery grafts after coronary artery bypass surgery: Results from a Department of Veterans Affairs Cooperative Study. J Am Coll Cardiol, 2004, 44(11): 2149-2156.
10. Ruttmann E, Dietl M, Feuchtner GM, et al. Long-term clinical outcome and graft patency of radial artery and saphenous vein grafts in multiple arterial revascularization. J Thorac Cardiovasc Surg, 2019, 158(2): 442-450.
11. Fanari Z, Weiss SA, Zhang W, et al. Comparison of percutaneous coronary intervention with drug eluting stents versus coronary artery bypass grafting in patients with multivessel coronary artery disease: Meta-analysis of six randomized controlled trials. Cardiovasc Revasc Med, 2015, 16(2): 70-77.
12. Papadopoulos K, Lekakis I, Nicolaides E. Outcomes of coronary artery bypass grafting versus percutaneous coronary intervention with second-generation drug-eluting stents for patients with multivessel and unprotected left main coronary artery disease. SAGE Open Med, 2017, 5: 2050312116687707.
13. Hu S, Li Q, Gao P, et al. Simultaneous hybrid revascularization versus off-pump coronary artery bypass for multivessel coronary artery disease. Ann Thorac Surg, 2011, 91(2): 432-438.
14. Kayatta MO, Halkos ME, Puskas JD. Hybrid coronary revascularization for the treatment of multivessel coronary artery disease. Ann Cardiothorac Surg, 2018, 7(4): 500-505.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Hybrid coronary revascularization versus off-pump coronary artery bypass grafting for treatment of multivessel coronary artery diseases

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