When an article did not disclose one or more of these outcome measures or reported medians and ranges as central tendency instead of means and standard deviations, the study was excluded from the analysis of that particular variable. 2.4. Statistical Analysis The selleck chem inhibitor results were analysed using IBM SPSS Statistics 19 software (IBM Inc., Armonk, NY, USA). Continuous data were presented as mean and standard deviation (SD), while categorical data were expressed as numbers and percentages. 3. Outline and Interpretation of the Results of HCR Nine hundred seventy patients undergoing HCR procedures were included for analysis (Tables (Tables11 and and2)2) [6, 7, 11�C14, 17�C28]. The most important findings are reported below. Table 1 Overview of 18 series describing hybrid coronary revascularization.

Table 2 Outcomes of 18 series describing hybrid coronary revascularization. 3.1. Patient Selection The classical indication for an HCR procedure is multivessel coronary artery disease involving LAD lesion judged suitable for minimally invasive LITA to LAD bypass grafting but unsuitable for PCI (type C), and (a) non-LAD lesion(s) (most of the time right coronary artery (RCA) and/or circumflex coronary artery (Cx) lesions) amenable to PCI (type A or B) [7, 11, 12, 14, 17, 18, 20, 22, 23, 26�C28]. High-risk patients especially with severe concomitant diseases (e.g., diabetes mellitus, malignancies, significant carotid disease, severely impaired LV function, and neurological diseases), who are more prone to develop complications after cardiopulmonary bypass and sternotomy, might benefit from the circumvention of CPB and sternotomy [11, 18, 20, 22�C24].

Exclusion criteria for HCR consist of contraindications to minimally invasive LITA to LAD bypass grafting or PCI. LITA to LAD bypass grafting in a minimally invasive fashion requires single-lung ventilation and chest cavity insufflation. Therefore, HCR procedures are contraindicated in patients with a compromised pulmonary function (i.e., forced expiratory volume in one second less than 50% of predicted) and a small intrathoracic cavity space [14, 27, 28]. Moreover, patients with a nongraftable or a buried intramyocardial LAD, history of left subclavian artery and/or LITA stenosis, morbid obesity (BMI > 40kg/m2), and previous left chest surgery are not well suited for minimally invasive LITA tot LAD bypass grafting [14, 20, 22, 27, 28].

Conditions rendering PCI unsuitable include peripheral vascular Dacomitinib disease precluding vascular access, coronary vessel diameter smaller than 1.5mm, tortuous calcified coronary vessels, fresh thrombotic lesions, chronic totally occluded coronary arteries, extensive coronary involvement, chronic renal insufficiency (serum creatinine �� 200��mol/L), and allergy to radiographic contrast [7, 14, 18, 20, 22, 27, 28].