ISMICS 17 Annual Scientific Meeting, 7-10 June 2017, Rome Cavalieri, Rome, Italy
ISMICS 17 Annual Scientific Meeting, 7-10 June 2017, Rome Cavalieri, Rome, Italy
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Hybrid Coronary Revascularization For Right Coronary Artery
Makoto Hashimoto, Hirosato Doi, Keijiro Mitsube, Satoshi Sumino, Ryuji Koshima.
Sapporo cardiovascular clinic, Sapporo, Hokkaido, Japan.

OBJECTIVE: Hybrid coronary revascularization (HCR) emerged as a new strategy in revascularization for the multivessel coronary artery disease. However, the optimal candidate for HCR is not discussed well, thus this study aimed to find it.
METHODS: Isolated CABG was performed in 445 patients at The Sapporo-Cardiovascular-Clinic between March 2012 and August 2016. Of these, 123 consecutive patients with surgical coronary revascularization (SCR) whose surgery was performed by a single surgeon (group-S) and 56 consecutive patients with HCR (group-H) were included. In group-H, percutaneous coronary intervention (PCI) was performed for right coronary artery (RCA) and SCR for the left coronary artery. Outcomes were compared between groups.
RESULTS: In group-H, sternal-sparing surgery was applied for 8 patients and median sternotomy was applied for the rest. Early outcomes were similar between groups. Freedom from RCA-revascularization was significantly higher in group-S than in group-H after 2years (93% vs. 78%, p=0.019). In group-H, low-SYNTAX-score (score 0-22) was associated with lower RCA-revascularization compared with the higher SYNTAX score (score 23+) group (3% vs. 33%, p=0.005). Freedom from RCA-revascularization after 2years was similar when group-S and low-SYNTAX-score cases in group-H were compared (95% vs. 93%, p=0.662).
CONCLUSIONS: Our results suggest that HCR is a feasible option only for the low-SYNTAX-score group. HCR for the higher SYNTAX score group should be avoided due to the poor remote outcome.


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