OBJECTIVES: The aim of this observational study was to evaluate the in-hospital and medium-term outcomes of hybrid coronary revascularization (HCR) in the real-world setting compared to conventional coronary artery bypass grafting (CABG). METHODS: All patients with multi-vessel coronary artery disease (MV-CAD) who underwent conventional CABG and HCR in our institution between January 2018 to January 2021 were evaluated in terms of length of intensive care unit (ICU), in-hospital stay, repeat revascularization rates, bleeding, stroke, and in-hospital mortality. Clinical outcomes (mortality and major adverse cardiac and cerebrovascular events [MACCE]) were assessed at average follow up of 3.6 years. RESULTS: Pre-procedural characteristics were balanced between the groups after propensity score matching. There was no significant difference in MACCE [Odds ratio: 0.57
95 % CI: 0.05 to 1.52
p = 0.66], in-hospital mortality [n = 2 (1.9 %) vs n = 0
p = 0.80], post procedure stroke [n = 2 (1.9 %) vs n = 2 (3.7 %)
p = 0.86], post-procedural myocardial infarction requiring repeat revascularization [n = 2 (1.9 %) versus n = 1 (1.9 %)
p = 1] during the in-hospital stay of the patients in the CABG vs HCR groups respectively. HCR was associated with significantly lower requirement for blood transfusions, bleeding risk, in-hospital stay, and intensive care unit stay. Analysis of the outcomes after 3.6 years revealed no significant difference in MACCE [Odds ratio: 1.40
95 % CI: 0.46 to 4.30
p = 0.55], and post discharge mortality [n = 0 vs n = 0
p = 1]. Both groups had similar rates of post-procedural myocardial infarction requiring repeat revascularization [n = 0 vs n = 4 (7.4 %)
p = 0.278], and rate of re-intervention [n = 0 vs n = 3 (5.6 %)
p = 0.41]. CONCLUSION: HCR may be considered as a safe and feasible alternative to conventional CABG in selected individuals with MV-CAD.