Hybrid Coronary Revascularization: Perspective Current State After 25 Years of Start


  • Ahmed Abdelrahman Elassal, MD King Abdulaziz University, Department of Surgery, Cardiac Surgery Unit, Jeddah, Saudi Arabia
  • Khalid Ebrahim Al-Ebrahim, FRCSC King Abdulaziz University, Department of Surgery, Cardiac Surgery Unit, Jeddah, Saudi Arabia
  • Adel Mohammad Makhdoom, MD King Abdulaziz University, Department of Anesthesia and Critical Care, Jeddah, Saudi Arabia
  • Mazin Adel Fatani, FRCSC Umm Al-Qura University, Department of Surgery, Makkah, Saudi Arabia
  • Mohamed Hasan Ibrahim, MD Benha University, Department of Cardiology, Benha, Egypt




Hybrid, Coronary bypass grafting, Percutaneous coronary intervention


Hybrid coronary revascularization (HCR) represents a minimally invasive revascularization strategy in which the durability of the internal mammary artery to the left anterior descending artery graft is combined with percutaneous coronary intervention to treat remaining lesions. It first was introduced in the mid-1990s and aspired to bring together the “best of both worlds” – the excellent patency rates and survival benefits associated with the durable left internal mammary artery graft to the left anterior descending artery alongside the good patency rates of drug-eluting stents, which outlive saphenous vein grafts to non–left anterior descending vessels. Although in theory this is a very attractive revascularization strategy, several years later, only small randomized controlled trials comparing HCR with coronary artery bypass grafting has recently emerged in the medical literature, raising concerns regarding HCR’s role. In the current review, we discuss HCR’s rationale, the current evidence behind it, its limitations, and procedural challenges.


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How to Cite

Elassal, A. A., Al-Ebrahim, khalid, Makhdoom, A. M., Fatani, M. ., & Ibrahim, M. (2021). Hybrid Coronary Revascularization: Perspective Current State After 25 Years of Start. The Heart Surgery Forum, 24(2), E392-E401. https://doi.org/10.1532/hsf.3693