Keyhole hybrid coronary revascularisation

Fri 10 June 2016

A surgical team from Beijing have recently published interesting data which demonstrates further support for keyhole hybrid coronary revascularisation.

Hybrid revascularisation involves performing keyhole bypass surgery to bypass one of the most important arteries on the heart, called the LAD (left anterior descending) artery. Other blockages can then be treated either immediately, or separately (either before or afterwards) using stents. The alternative is to perform bypass grafts to all blockages through the breastbone.

In this study, Hybrid keyhole revscularisation was compared with beating heart surgery via the breastbone. Interestingly, the hybrid keyhole therapy offered:

  • Significantly reduced postoperative bleeding
  • Significantly reduced blood transfusion rate
  • Significantly shorter time on the ventilator
  • Significantly shorter stay on intensive care

Patients in both groups were followed up over 30 months and the incidence of cardiovascular problems were no different. Interestingly though, one stop hybrid keyhole revascularisation seemed to have a lower stroke rate at 3 years (0% versus 3.6%; p-0.046 suggesting statistically significant benefit)

The authors concluded:

“For selected patients with DM, one-stop HCR provided safe and reproducible revascularization, with less perioperative invasiveness and similar and favorable midterm outcomes compared with OPCAB.”


Hybrid revascularisation performed by experienced teams in selected patients offers compelling advantages which include quicker recovery and reduced complications compared to sternotomy. Experience is critical in allowing patients to appreciated these benefits.

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