One-year clinical and angiographic results of hybrid myocardial revascularization: Still a long way to go

Abstract

Coronary artery bypass grafting (CABG) is the mainstay of the surgical treatment of multivessel coronary artery disease. In the past 50 years, CABG has been analyzed through countless contributions, including randomized trials and observational single-institution studies. When attempting to define the keycomponent of success of CABG,it is likely that the use of the left internal thoracic artery (LITA) to revascularize the left anterior descending coronary artery (LAD) under cardioplegic arrest will be acknowledged by a significant proportion of the medical and surgical community.Thiswas highlightedbyLoopandcolleagues 1 fromthe Cleveland Clinic in a seminal contribution. Loop 2 defined the major factors that have influenced the indications for surgery in patients with left ventricular dysfunction as viableornonviablemyocardium,improvedmyocardial protection and intra-aortic balloon pumping, internal thoracic artery grafting, and left ventricular restorative procedures. Furthermore, current knowledge indicates that the use of a second arterial graft, mostly the right internal thoracic artery, adds long-term survival benefit in addition to higher patency with respect vein grafts, 3 such as complete arterial