Abstract: Objective · To explore the difference between hybrid coronary revascularization (HCR) and off-pump coronary artery bypass grafting(OPCABG) on two-vessel coronary artery disease with proximal left anterior descending stenosis with propensity score matching. Methods · The patients with two-vessel coronary artery disease with proximal left anterior descending stenosis who underwent isolated HCR or OPCABG were selected in Ruijin Hospital January 2009 to December 2016. The propensity score methodology was used to obtain risk-adjusted outcome. Kaplan-Meier analysis was applied to estimation of major adverse cardiac and cerebrovascular events (MACCE)-free survival rate and target vessel revascularization (TVR)-free survival rate. Results · The average follow-up time was 59 months (13–104 months). The length of hospital stay of HCR group was significantly shorter than that of OPCABG group [(15.3±4.5) d vs (17.6±5.4) d, P0.027]. There was no statistical difference in other short-term clinical endpoints in hospital. In midterm, there was no statistical difference in the rate of MACCE (11.4% vs 13.3%, P0.968), death (2.3% vs 4.4%, P0.984), myocardial infarction(2.3% vs 2.2%, P0.485), stroke (4.5% vs 6.7%, P0.979) and TVR (4.5% vs 2.2%, P0.984) between two groups. And there was no statistical difference in MACCE-free survival rate (P0.906) and TVR-free survival rate (P0.541) between two groups. Conclusion · HCR provides favorable midterm outcomes for selected patients with two-vessel coronary artery disease with proximal left anterior descending stenosis. It might provide a promising alternative to OPCABG.

Key words: hybrid coronary revascularization, off-pump coronary artery bypass grafting, propensity score matching