Feature | November 04, 2013

Hybrid Procedure Feasible, Safe Compared to Traditional CABG

Results of the HYBRID Trial Presented at TCT 2013

November 4, 2013 — A hybrid approach to treating coronary artery disease that involves a hybrid procedure combining a minimally invasive bypass surgery with percutaneous coronary intervention (PCI) was found to be feasible and safe in a clinical trial. This is the first randomized study of the technique. These findings were presented at the 25th annual Transcatheter Cardiovascular Therapeutics scientific symposium (TCT 2013).
Hybrid coronary artery revascularization (HCR), as studied within this trial, combined a minimally invasive left internal mammary artery bypass grafting to the left anterior descending artery (LAD) with percutaneous coronary intervention (PCI) with drug-eluting stent (DES) implantation to other coronary arteries. Due to the lack of data from large, prospective, randomized trials comparing HCR with standard surgical revascularization, HYBRID was designed as a feasibility study to assess the safety and efficacy of HCR in patients with multi-vessel coronary artery disease referred for standard coronary artery bypass grafting (CABG).
Two hundred consecutive patients, with angiographically confirmed multi-vessel coronary artery disease (CAD) involving the LAD and a critical (> 70 percent) lesion in at least one major epicardial vessel (except LAD) amenable to both PCI and CABG, were randomized in a one-to-one fashion to HCR or standard surgical revascularization.
The primary objectives of this trial were to investigate the feasibility and safety of HCR. The feasibility assessment was defined both as the percentage of patients in the hybrid group that had a complete HCR procedure according to the study protocol and a percentage that had to be converted to standard CABG. The safety endpoint was the occurrence of major adverse cardiac events (MACE) such as death, myocardial infarction, stroke, repeat revascularization or major bleeding within the 12-month period after randomization. 
In the trial, 93.9 percent of the patients in the hybrid group had the completed HCR procedure and 6.1 percent were converted to CABG.  
At one year, 92.2 percent of the CABG group and 89.8 percent of the hybrid group were free from MACE. No strokes were reported in either group. The rate of death was 2.9 percent in the CABG group and 2.0 percent in the HCR group.
“This first randomized pilot study on hybrid coronary revascularization shows promising feasibility and safety results supporting the idea of hybrid coronary revascularization in patients with multi-vessel disease,” said Michal Hawranek, M.D, Ph.D., on behalf of the investigation team at the Silesian Center for Heart Disease, Zabrze, Poland. 
For more information: www.crf.org

Related Content

Gecko Biomedical Receives CE Mark Approval for Setalum Sealant
News | Cardiovascular Surgery | September 19, 2017
Gecko Biomedical announced it has received CE Mark approval for its Setalum Sealant, allowing the company to market its...
ClearFlow Inc. Announces Positive U.S. Clinical Trial Results
News | Cardiovascular Surgery | September 08, 2017
September 8, 2017 — ClearFlow Inc.
Videos | Cardiovascular Surgery | July 19, 2017
This video educational session, provided in partnership with the American Society of Echocardiography (ASE), is title
Intensive Glycemic Control Program Produces Significant Per-Patient Cost Savings for CABG Surgery
News | Cardiovascular Surgery | May 25, 2017
A new study from Emory University observed a near-20 percent reduction in perioperative complications, a 1.2-day...
Risk of Heart Transplant Rejection Reduced by Desensitizing Patient Antibodies
News | Cardiovascular Surgery | May 23, 2017
The risk of heart transplant rejection can be reduced by desensitizing patient antibodies, according to research...
Scientists Show How Cells React to Injury From Open-Heart Surgery
News | Cardiovascular Surgery | May 04, 2017
Cedars-Sinai Heart Institute investigators have learned how cardiac muscle cells react to a certain type of injury that...
ERACS Session Highlights Need for Standardized Best Practices in Cardiac Surgery
News | Cardiovascular Surgery | May 02, 2017
The recently formed group Enhanced Recovery After Cardiac Surgery (ERACS) hosted an organizing session in Boston on...
ClearFlow Receives Frost & Sullivan New Product Innovation Award for PleuraFlow Technology
News | Cardiovascular Surgery | May 01, 2017
ClearFlow Inc. has received the prestigious 2017 Global Frost & Sullivan Award for New Product Innovation. The...
Edwards Intuity Elite sutureless aortic valve, first implants in Connecticut, WCHN, Western Connecticut Health Network
News | Cardiovascular Surgery | February 16, 2017
Western Connecticut Health Network (WCHN) cardiothoracic surgeons Cary Passik, M.D., and Robert Gallagher, M.D., were...
open-heart surgery, PCI, percutaneous coronary intervention, NOBLE trial, left main coronary artery disease, LMCAD, TCT 2016
News | Cardiovascular Surgery | November 03, 2016
Coronary artery bypass (CABG) surgery is the standard treatment for revascularization in patients with left main...
Overlay Init