Table 2.

Advantages and Limitations of Use of Various HCR Approaches

Factor	One-Setting	CABG Followed by PCI	PCI Followed by CABG
LIMA-LAD patency	Assessment directly after completing anastomosis	Assessment during follow-up PCI	Not routinely assessed
Suitable in non-elective setting	No	No	Yes
PCI of complex lesions	Possible	Possible	Possible, but more risky with non-revascularized LAD
Arterial access for PCI	Obtain before anticoagulation administered for surgery	Obtain at the time of PCI	Obtain at the time of PCI
Anticoagulation	Administered once	Administered twice	Administered twice
Discontinue DAPT	No	No	Yes/No
Risk for intraoperative bleeding	High	Low	High (if DAPT continued)
Risk of acute stent thrombosis	Intermediate	Low	High
DES use	Suitable	Suitable	Not suitable
LOS	Likely to be shorter	Likely to be longera	Likely to be longera
Degree of coordination between teams	High degree of coordination	Lesser degree of coordination	Lesser degree of coordination
Costs	Hybrid room	Two procedures	Two procedures
	Training of personnel	Reimbursement	Reimbursement
	Reimbursement

^aThe difference between LOS in 1-setting and staged settings depends primarily on the time interval between the 2 staged procedures.

CABG = coronary artery bypass graft; DAPT = dual antiplatelet therapy; DES = drug-eluting stent; LAD = left anterior descending artery; LIMA = left internal mammary artery; LOS = length-of-stay; PCI = percutaneous coronary intervention.