Hybrid Coronary Revascularization Versus Off‐Pump Coronary Artery Bypass Grafting: Comparative Effectiveness Analysis With Long‐Term Follow‐up
Bibliographic record
Abstract
Background Hybrid coronary revascularization ( HCR ) involves the integration of coronary artery bypass grafting ( CABG ) and percutaneous coronary intervention to treat multivessel coronary artery disease. Our objective was to perform a comparative analysis with long‐term follow‐up between HCR and conventional off‐pump CABG . Methods and Results We compared all double off‐pump CABG (n=216) and HCR (n=147; robotic‐assisted minimally invasive direct CABG of the left internal thoracic artery to the left anterior descending artery and percutaneous coronary intervention to one of the non–left anterior descending vessels) performed at a single institution between March 2004 and November 2015. To adjust for the selection bias of receiving either off‐pump CABG or HCR , we performed a propensity score analysis using inverse‐probability weighting. Both groups had similar results in terms of re‐exploration for bleeding, perioperative myocardial infarction, stroke, blood transfusion, in‐hospital mortality, and intensive care unit length of stay. HCR was associated with a higher in‐hospital reintervention rate ( CABG 0% versus HCR 3.4%; P =0.03), lower prolonged mechanical ventilation (>24 hours) rate (4% versus 0.7%; P =0.02), and shorter hospital length of stay (8.1±5.8 versus 4.5±2.1 days; P <0.001). After a median follow‐up of 81 (48–113) months for the off‐pump CABG and 96 (53–115) months for HCR , the HCR group of patients had a trend toward improved survival (85% versus 96%; P =0.054). Freedom from any form of revascularization was similar between the 2 groups (92% versus 91%; P =0.80). Freedom from angina was better in the HCR group (73% versus 90%; P <0.001). Conclusions HCR seems to provide, in selected patients, a shorter postoperative recovery, with similar excellent short‐ and long‐term outcomes when compared with standard off‐pump CABG .
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".