Hybrid Coronary Revascularization: An Overview of Options for Anticoagulation and Platelet Inhibition
DOI:
https://doi.org/10.1532/HSF98.20101157Abstract
Background: Hybrid coronary revascularization, in which coronary bypass grafting is combined with percutaneous coronary intervention, is a promising strategy for optimizing outcomes in the treatment of coronary artery disease. Balancing the risk of surgical bleeding with the risk of percutaneous coronary intervention-related thrombosis is a major challenge inherent in carrying out a successful procedure and requires careful selection of antiplatelet and anticoagulant agents.
Methods: Advantages and disadvantages of antiplatelet and anticoagulant agents in use today for hybrid coronary revascularization are reviewed.
Results: Currently available anticoagulants and platelet inhibitors have been used to provide safe and effective protection from thrombosis while limiting surgical bleeding in hybrid coronary revascularization, but there is no agreement on an optimal strategy, and each patient presents a unique pharmacologic and logistic puzzle.
Conclusion: Knowledge of the salient features of the available medications will allow the cardiologist and surgeon to design the optimal strategy for each patient.
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