title: Midterm outcomes of simultaneous hybrid coronary artery revascularization for left main coronary artery disease.
abstract: BACKGROUND
  The purpose of this study was to evaluate the feasibility, safety, and midterm outcomes of a simultaneous hybrid revascularization strategy for left main coronary artery disease (LMCAD), compared with conventional off-pump coronary artery bypass grafting (OPCAB).
  
  
  METHODS
  We compared the in-hospital and midterm outcomes of a simultaneous hybrid revascularization strategy (minimally invasive direct coronary bypass grafting of the left anterior descending coronary artery [LAD] and percutaneous intervention to non-LAD lesions) in 20 patients with LMCAD in an enhanced operating room. These patients were matched by propensity score to a group of 20 control patients who underwent standard OPCAB between September 2007 and December 2009.
  
  
  RESULTS
  All baseline clinical characteristics of the 2 groups were similar. All of the patients in the 2 groups underwent surgery uneventfully without conversion to on-pump coronary artery bypass grafting. Compared with OPCAB, the patients in the hybrid group had shorter lengths of stay in the intensive care unit (34.8 ± 37.6 hours versus 50.7 ± 34.5 hours, P = .01). Transfusion requirements were reduced in the hybrid patients compared with the OPCAB patients (5% versus 40%, P = .01). The 2 groups did not differ with respect to the occurrence of other important morbidities. During the mean (±SD) follow-up of 18.5 ± 9.8 months, the group of patients who underwent the simultaneous hybrid procedure experienced an incidence of major adverse cardiac or cerebrovascular events that was similar to that of the OPCAB control group (100% versus 90%, respectively; P = .31).
  
  
  CONCLUSIONS
  The midterm follow-up indicated that the simultaneous hybrid revascularization procedure for LMCAD is feasible, safe, and effective. These promising early findings warrant further prospective investigations.
authors.affiliation: Department of Surgery, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China. shengshouhu@yahoo.com
authors.forename: Sheng-Shou
authors.initials: SS
authors.lastname: Hu
authors.forename: Hui
authors.initials: H
authors.lastname: Xiong
authors.forename: Zhe
authors.initials: Z
authors.lastname: Zheng
authors.forename: Peixian
authors.initials: P
authors.lastname: Gao
authors.forename: Changwei
authors.initials: C
authors.lastname: Zhang
authors.forename: Runlin
authors.initials: R
authors.lastname: Gao
authors.forename: Lihuan
authors.initials: L
authors.lastname: Li
authors.forename: Jinqing
authors.initials: J
authors.lastname: Yuan
authors.forename: Bo
authors.initials: B
authors.lastname: Xu
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation / Q000379:methods*; D016022:Case-Control Studies; D001026:Coronary Artery Bypass / Q000379:methods; D003324:Coronary Artery Disease / Q000601:surgery* / Q000628:therapy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome