The Efficacy Of Hybrid Coronary Revascularization Versus CABG In The Treatment Of Multi-vessel Coronary Artery Disease In China:a Meta-analysis

Objective: The latest literature was used to systematically evaluate the perioperative and long-term effects of hybrid coronary artery revascularization(HCR)and traditional coronary artery bypass grafting(CABG)in the treatment of multi-vessel coronary artery disease in China.Methods: According to the retrieval strategy,the common databases at home and abroad(Pubmed,Embase,Cochrane Library,How Net,Wanfang and other databases)are comprehensively searched.Relevant studies on HCR and CABG in the treatment of multiple coronary artery diseases in China before January 2023 were retrieved in Chinese and English.After the retrieval,the preliminarily included documents are screened,evaluated and extracted according to the pre-determined standards.The 24 outcome indicators involved were statistically processed with Review Manager5.4 and Stata 16.0 software,and the results were systematically evaluated.Results: According to the established search strategies and screening criteria,a total of 18 literatures were included in this meta-analysis,including a total of 4380 patients,including 1677 patients in the HCR group and 2703 patients in the CABG group.The results of meta-analysis showed that:(1)The incidence of postoperative blood transfusion(P < 0.05),the average length of hospital stay(P < 0.05),the average length of ICU stay(P < 0.05),and the average postoperative mechanical ventilation time(P < 0.05)were all better in the HCR group than in the CABG group.(2)CABG group was superior to HCR group in long-term target vessel revascularization rate(P < 0.05)and hospitalization cost(P < 0.05).(3)There was no significant difference between the two groups in perioperative and mid-term(mortality rate,rate of new myocardial infarction,rate of cerebrovascular accident,rate of target vessel revascularization,and rate of MACCE),long-term(mortality rate,rate of new myocardial infarction,rate of cerebrovascular accident,and rate of MACCE),postoperative reoperation rate due to bleeding,postoperative new atrial fibrillation,postoperative renal function loss,and operation time Difference(P >0.05).Conclusions: HCR has no inferior effect to CABG in the treatment of coronary artery disease in China,especially in the aspects of blood transfusion,hospital stay,ICU hospital stay and postoperative mechanical ventilation.Although the long-term target vessel reconstruction rate of HCR is higher,in view of its long-term composite MACCE rate is not behind CABG,we believe that HCR has a good development prospect.Under certain conditions,HCR may be a safe,feasible,effective and promising surgical method for MVCAD patients in China.