Hybrid coronary revascularization <i>vs</i>. percutaneous coronary interventions for multivessel coronary artery disease

Edward L. Hannan; Yi-Feng WU; Kimberly Cozzens; Jacqueline Tamis-Holland; Frederick S.K. Ling; Alice K. Jacobs; Ferdinand J. Venditti; Peter B. Berger; Gary Walford; Spencer B. King, III

doi:10.11909/j.issn.1671-5411.2021.03.003

Volume 18 Issue 3

Mar. 2021

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Article Navigation > Journal of Geriatric Cardiology > 2021 > 18(3): 159-167

Please cite this article as: Hannan EL, Wu YF, Cozzens K, Tamis-Holl J, Ling FSK, Jacobs AK, Venditti FJ, Berger PB, Walford G, King, III SB. Hybrid coronary revascularization vs . percutaneous coronary interventions for multivessel coronary artery disease. J Geriatr Cardiol 2021; 18(3): 159−167. DOI: 10.11909/j.issn.1671-5411.2021.03.003

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Please cite this article as: Hannan EL, Wu YF, Cozzens K, Tamis-Holl J, Ling FSK, Jacobs AK, Venditti FJ, Berger PB, Walford G, King, III SB. Hybrid coronary revascularization vs . percutaneous coronary interventions for multivessel coronary artery disease. J Geriatr Cardiol 2021; 18(3): 159−167. DOI: 10.11909/j.issn.1671-5411.2021.03.003

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Hybrid coronary revascularization vs. percutaneous coronary interventions for multivessel coronary artery disease

doi: 10.11909/j.issn.1671-5411.2021.03.003

1.
University at Albany, State University of New York, Albany, NY, USA
2.
Mount Sinai St. Luke’s Hospital, New York, NY, USA
3.
University of Rochester Medical Center, Rochester, NY, USA
4.
Boston Medical Center, Boston, MA, USA
5.
Albany Medical Center, Albany, NY, USA
6.
Unaffiliated
7.
Johns Hopkins Medical Center
8.
Emory Health System, Atlanta, GA, USA

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Corresponding author: edward.hannan@health.ny.gov
Available Online: 2021-04-07
Publish Date: 2021-03-31

Abstract

Abstract

OBJECTIVE Hybrid coronary revascularization (HCR) combines a minimally invasive surgical approach to the left anterior descending (LAD) artery with percutaneous coronary intervention (PCI) for non-LAD diseased coronary arteries. It is associated with shorter hospital lengths of stay and recovery times than conventional coronary artery bypass surgery, but there is little information comparing it to isolated PCI for multivessel disease. Our objective is to compare long-term outcomes of HCR and PCI for patients with multivessel disease. METHODS This cohort study used data from New York’s cardiac surgery and PCI registries in 2010−2016 to examine mortality and repeat revascularization rates for patients with multivessel coronary artery disease who underwent HCR and PCI. Cox proportional hazards methods were used to reduce selection bias. Patients were followed for a median of four years. RESULTS There was a total of 335 HCR patients (1.2%) and 25,557 PCI patients (98.8%) after exclusions. There was no difference in 6-year risk adjusted survival between HCR and PCI patients (83.17% vs. 81.65%, adjusted hazard ratio (aHR) = 0.90 (95% CI: 0.67−1.20). However, HCR patients were more likely to be free from repeat revascularization in the LAD artery (91.13% vs. 83.59%, aHR = 0.51 (95% CI: 0.34−0.77)). CONCLUSIONS For patients with multi-vessel coronary artery disease, HCR is rarely performed. There are no differences in mortality rates after four years, but HCR is associated with lower repeat revascularization rates in the LAD artery, presumably due to better longevity in left arterial mammary grafts.

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References(30)

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