title: A nationwide survey on perception, experience, and expectations of hybrid coronary revascularization among top-ranked US hospitals.
abstract: BACKGROUND
  Hybrid coronary revascularization (HCR) combines a surgical and percutaneous approach for treatment of multivessel coronary artery disease.
  
  
  METHODS
  A survey was conducted among 200 cardiologists and cardiac surgeons from 100 top-ranked US hospitals. Questions were asked involving the perception, experience, and future expectations of HCR.
  
  
  RESULTS
  Of physicians invited to the survey, 90 completed the survey (45.5%). Relative to nonresponders, responders were more often affiliated with an academic institution (80.0% vs 61.8%, P=.005), with higher patient volumes, and with the availability of a hybrid operating room (90.0% vs 67.3%, P<.001). Survey responders felt that HCR should be considered in an older and relatively healthy patient population without complex lesions. Cardiac surgeons were more favorable to use HCR in patients with chronic lung disease (42.0% vs 10.0%, P<.001) or renal failure (28.0% vs 15.0%, P=.06). Among responders with HCR experience (n=54), 94% reported good to excellent results, and the learning curve differed depending on the surgical technique used. Inappropriate patient selection (41.2%) was the most common cause for complications. Three-quarter of responders believe that the future role for HCR will expand in the next decade. Important determinants of greater HCR use in the future were collaborative associations between cardiac surgeons and cardiologists (86.7%), appropriate patient selection (67.8%), and the outcomes of ongoing clinical trials (57.8%).
  
  
  CONCLUSIONS
  In this nationwide survey, cardiologists and cardiac surgeons felt that HCR is a reasonable alternative technique for coronary revascularization among suitable patients. Most felt that use of HCR would increase in the next decade.
authors.affiliation: Duke Clinical Research Institute, Durham, NC; Academic Medical Center-University of Amsterdam, Amsterdam, The Netherlands. Electronic address: r.e.harskamp@gmail.com.
authors.forename: Ralf E
authors.initials: RE
authors.lastname: Harskamp
authors.affiliation: Emory University, Atlanta, GA.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Halkos
authors.affiliation: Duke Clinical Research Institute, Durham, NC.
authors.forename: Ying
authors.initials: Y
authors.lastname: Xian
authors.affiliation: The Heart Hospital Baylor, Plano, TX.
authors.forename: Molly A
authors.initials: MA
authors.lastname: Szerlip
authors.affiliation: University of Arizona Medical Center, Tucson, AZ.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Poston
authors.affiliation: Cleveland Clinic, Cleveland, OH.
authors.forename: Stephanie L
authors.initials: SL
authors.lastname: Mick
authors.affiliation: Duke Clinical Research Institute, Durham, NC.
authors.forename: Renato D
authors.initials: RD
authors.lastname: Lopes
authors.affiliation: Academic Medical Center-University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Jan G
authors.initials: JG
authors.lastname: Tijssen
authors.affiliation: Academic Medical Center-University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Robbert J
authors.initials: RJ
authors.lastname: de Winter
authors.affiliation: Duke Clinical Research Institute, Durham, NC.
authors.forename: Eric D
authors.initials: ED
authors.lastname: Peterson
mesh_terms: D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D009204:Myocardial Revascularization / Q000379:methods*; D011159:Population Surveillance / Q000379:methods*; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology