title: Hybrid coronary revascularization: an overview of options for anticoagulation and platelet inhibition.
abstract: 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.
  
  
  CONCLUSIONS
  Knowledge of the salient features of the available medications will allow the cardiologist and surgeon to design the optimal strategy for each patient.
authors.affiliation: Division of Cardiology and Cardiac Surgery, University of Maryland School of Medicine, Baltimore, MD, USA. dzimrin@medicine.umaryland.edu
authors.forename: David
authors.initials: D
authors.lastname: Zimrin
authors.forename: Johannes
authors.initials: J
authors.lastname: Bonatti
authors.forename: Mark R
authors.initials: MR
authors.lastname: Vesely
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Lehr
mesh_terms: D000925:Anticoagulants / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D006801:Humans; D009204:Myocardial Revascularization / Q000009:adverse effects*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D019106:Postoperative Hemorrhage / Q000188:drug therapy / Q000209:etiology* / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors