Author + information
- Received April 30, 2014
- Revision received May 15, 2014
- Accepted May 22, 2014
- Published online November 1, 2014.
- Mariusz Gąsior, MD∗,
- Michael Oscar Zembala, MD, PhD†,
- Mateusz Tajstra, MD, PhD∗∗ (, )
- Krzysztof Filipiak, MD, PhD†,
- Marek Gierlotka, MD∗,
- Tomasz Hrapkowicz, MD, PhD†,
- Michał Hawranek, MD, PhD∗,
- Lech Poloński, MD∗,
- Marian Zembala, MD†,
- POL-MIDES (HYBRID) Study Investigators
- ∗Third Department of Cardiology, Silesian Center for Heart Diseases, Medical University of Silesia, Zabrze, Poland
- †Department of Cardiac Surgery and Transplantology, Silesian Center for Heart Diseases, Medical University of Silesia, Zabrze, Poland
- ↵∗Reprint requests and correspondence:
Dr. Mateusz Tajstra, Silesian Center for Heart Diseases, Ul. Szpitalna 2, 41-800 Zabrze, Poland.
Objectives The aim of this study was to assess the feasibility of hybrid coronary revascularization (HCR) in patients with multivessel coronary artery disease (MVCAD) referred for standard coronary artery bypass grafting (CABG).
Background Conventional CABG is still the treatment of choice in patients with MVCAD. However, the limitations of standard CABG and the unsatisfactory long-term patency of saphenous grafts are commonly known.
Methods A total of 200 patients with MVCAD involving the left anterior descending artery (LAD) and a critical (>70%) lesion in at least 1 major epicardial vessel (except the LAD) amenable to both PCI and CABG and referred for conventional surgical revascularization were randomly assigned to undergo HCR or CABG (in a 1:1 ratio). The primary endpoint was the evaluation of the safety of HCR. The feasibility was defined by the percent of patients with a complete HCR procedure and the percent of patients with conversions to standard CABG. The occurrence of major adverse cardiac events such as death, myocardial infarction, stroke, repeated revascularization, and major bleeding within the 12-month period after randomization was also assessed.
Results Most of the pre-procedural characteristics were similar in the 2 groups. Of the patients in the hybrid group, 93.9% had complete HCR and 6.1% patients were converted to standard CABG. At 12 months, the rates of death (2.0% vs. 2.9 %, p = NS), myocardial infarction (6.1% vs. 3.9%, p = NS), major bleeding (2% vs. 2%, p = NS), and repeat revascularization (2% vs. 0%, p = NS) were similar in the 2 groups. In both groups, no cerebrovascular incidents were observed.
Conclusions HCR is feasible in select patients with MVCAD referred for conventional CABG. (Safety and Efficacy Study of Hybrid Revascularization in Multivessel Coronary Artery Disease [POL-MIDES]; NCT01035567).
The POL-MIDES (HYBRID) study was funded by the Ministry of Science and Higher Education of Poland (Project of National Research and Development Center, number 13 008406). The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received April 30, 2014.
- Revision received May 15, 2014.
- Accepted May 22, 2014.
- American College of Cardiology Foundation