Current trends in hybrid coronary revascularization

Magdalena Synak; Mateusz Hulbój; Witold Gerber; Paweł Kaźmierczak; Piotr P. Buszman; Krzysztof Sanetra

doi:10.5114/kitp.2025.154849

eISSN: 1897-4252
ISSN: 1731-5530

Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery

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3/2025
vol. 22

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abstract:

Review paper

Current trends in hybrid coronary revascularization

Magdalena Synak

¹

,

Mateusz Hulbój

²

,

Witold Gerber

^{3, 4}

,

Paweł Kaźmierczak

⁵

,

Piotr P. Buszman

^{1, 6, 7}

,

Krzysztof Sanetra

^{3, 8}

Department of Cardiology, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland
Department of Cardiology, Academy of Silesia, Katowice, Poland
Department of Cardiac Surgery, American Heart of Poland, Bielsko-Biala, Poland
Department of Cardiac Surgery, Academy of Silesia, Katowice, Poland
American Heart of Poland, Katowice, Poland
Department of Cardiology, American Heart of Poland, Bielsko-Biala, Poland
Center for Cardiovascular Research and Development, American Heart of Poland, Katowice, Poland
Division of Cardiovascular Surgery, Collegium Medicum, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland

Kardiochirurgia i Torakochirurgia Polska 2025; 22 (3): 190-198

DOI: https://doi.org/10.5114/kitp.2025.154849

Online publish date: 2025/10/29

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Introduction
Hybrid coronary revascularization (HCR) is a combined approach for multivessel coronary artery disease (MVD), integrating surgical grafting of the left internal mammary artery (LIMA) to the left anterior descending artery (LAD) with percutaneous coronary intervention (PCI) for non-LAD lesions. It aims to reduce invasiveness while maintaining effectiveness.

Aim
To summarize current evidence on the safety, effectiveness, and clinical outcomes of HCR compared to coronary artery bypass grafting (CABG), PCI, and off-pump coronary artery bypass (OPCAB).

Methods
A review of current literature including clinical trials, meta-analyses, and observational studies was conducted. Focus was placed on procedural techniques, patient selection, and outcomes.

Results
HCR is associated with shorter hospital stays, reduced bleeding, and faster recovery compared to CABG. Compared to PCI, it shows improved LAD patency and fewer repeat interventions. Outcomes are similar to OPCAB, with lower myocardial injury. Despite its benefits, HCR remains underused due to technical demands and limited availability of hybrid facilities.

Conclusions
Further randomized trials are needed to confirm its long-term safety, effectiveness, and cost-efficiency.

keywords:

Current trends in hybrid coronary revascularization

Magdalena Synak 1 , Mateusz Hulbój 2 , Witold Gerber 3, 4 , Paweł Kaźmierczak 5 , Piotr P. Buszman 1, 6, 7 , Krzysztof Sanetra 3, 8

coronary artery bypass grafting, angioplasty, hybrid coronary revascularization

Magdalena Synak

¹

,

Mateusz Hulbój

²

,

Witold Gerber

^{3, 4}

,

Paweł Kaźmierczak

⁵

,

Piotr P. Buszman

^{1, 6, 7}

,

Krzysztof Sanetra

^{3, 8}