Abstract 15225: Hybrid Coronary Revascularization versus Percutaneous Coronary Intervention for True Left Main Bifurcation Lesions

Introduction: Hybrid coronary revascularization (HCR) is an alternative and feasible treatment for true left main bifurcation lesion.

Aims: This study sought to compare the clinical outcomes of patients with true left main bifurcation lesions undergoing revascularization by HCR or percutaneous coronary intervention (PCI).

Methods: This was a propensity-matched cohort study. From March 1, 2010, to March 31, 2018, 40 consecutive patients with true left main bifurcation lesions underwent HCR at Fuwai Hospital. These patients were matched 1:1 to 40 contemporaneous patients who underwent PCI. The primary endpoint was major adverse cardiac and cerebrovascular events (MACCE), a composite of cardiac mortality, myocardial infarction, stroke, and repeat revascularization.

Results: There were no differences in patient characteristics between the two groups. During a mean follow-up of 2 years, MACCE occurred in 12 patients (3 in the HCR group and 9 in the PCI group). Kaplan-Meier survival analyses indicated that the cumulative incidence of MACCE (log-rank test, p = 0.026) and repeat revascularization ( p = 0.011) in the HCR group were significantly lower than those in the PCI group.

Conclusions: Compared with PCI, HCR demonstrated satisfactory mid-term outcomes in MACCE for true left main bifurcation lesions.