Cardiothoracic Surgery, Montefiore-Einstein Heart Center, Bronx, New York 10461, USA.
Semin Thorac Cardiovasc Surg. 2009 Fall;21(3):229-36. doi: 10.1053/j.semtcvs.2009.08.004.
The long-term benefits of a left internal mammary artery bypass graft to the left anterior descending artery (LAD) have been well described. As the patient population with multivessel coronary artery disease has grown older with greater comorbidities, less invasive approaches to revascularization have been explored. The use of drug-eluting stents has minimized the morbidity of revascularization but has failed to match the durability of coronary artery bypass grafting (CABG). Hybrid coronary revascularization (HCR) is the planned use of minimally invasive surgical techniques for left internal mammary artery-LAD grafting and the use of percutaneous coronary interventions (PCI) for non-LAD target revascularization. The optimal timing and order of revascularization in HCR remains unclear. Novel operating suites with surgical and fluoroscopic capabilities have begun to support the performance of simultaneous minimally invasive CABG and PCI. The role of HCR compared to both PCI and conventional CABG awaits the results of ongoing randomized clinical trials.
左内乳动脉旁路移植至左前降支（LAD）的长期益处已得到充分描述。随着患有多支冠状动脉疾病的患者人群年龄的增长和合并症的增多，人们探索了采用创伤更小的血运重建方法。药物洗脱支架的使用降低了血运重建的发病率，但未能达到冠状动脉旁路移植术（CABG）的耐久性。杂交冠状动脉血运重建（HCR）是计划采用微创外科技术进行左内乳动脉-LAD 搭桥，以及采用经皮冠状动脉介入治疗（PCI）进行非 LAD 靶血管血运重建。HCR 中血运重建的最佳时机和顺序尚不清楚。具有手术和透视功能的新型手术室开始支持同时进行微创 CABG 和 PCI。与 PCI 和常规 CABG 相比，HCR 的作用有待于正在进行的随机临床试验的结果。
