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We summarize the evidence on the new strategies for coronary artery bypass grafting (CABG). Hybrid CABG implies surgical grafting of the left anterior descending artery and percutaneous treatment of the other target vessels, with the promise of combining the durable benefits of surgery with the less invasive approach of percutaneous coronary interventions. Robotic CABG and minimally invasive CABG are performed through minimal incision or port access with dedicated equipment and instruments. Anaortic coronary artery bypass refers to off-pump CABG using only in-situ grafts. The use of multiple arterial grafts has been shown to improve patency and is potentially associated with better clinical outcomes. All these techniques require dedicated training and are more complex than conventional CABG but can significantly improve the results of surgery. Validation of the results of these new approaches in large randomized trials is a priority for the surgical community.

Original publication




Journal article



Publication Date





2160 - 2168


cardiac surgical procedures, coronary artery bypass, myocardial revascularization, Combined Modality Therapy, Coronary Artery Bypass, Coronary Artery Disease, Coronary Circulation, Coronary Vessels, Diffusion of Innovation, Humans, Percutaneous Coronary Intervention, Postoperative Complications, Risk Factors, Robotic Surgical Procedures, Treatment Outcome, Vascular Patency