Hybrid CABG/PCI Advances in surgical techniques and the introduction of DES have provided a platform for a hybrid revascularization strategy that combines grafting the LAD artery with the LIMA and stenting the non-LAD arteries with DES (instead of bypassing them with SVGs). Although preliminary data1261 have indicated that a hybrid strategy may be a reasonable alternative in some patients with multivessel CAD, its real effect will not be known until results of RCTs are avail- able.1261 The primary purpose of performing hybrid CABG is to decrease the morbidity rate of traditional CABG in high-risk patients. Although hybrid revascularization is most often performed in a staged fashion, a simultaneous hybrid procedure can be performed in a hybrid suite, offering several potential advantages, including improving the efficiency and cost-effectiveness of therapy as well as condensing therapy into 1 patient encounter. If a staged approach is chosen, minimally invasive CABG performed first, followed days later by PCI, is probably preferable, so as to enable surgery without the unwanted effects of antiplatelet therapy as well as to enable complete angiography of the LIMA graft at the time of PCI. The major disadvantage of this approach is that if complications occur with PCI, a third procedure may be necessary. Even with a hybrid suite, one of the most substan- tive barriers to simultaneous minimally invasive CABG and PCI is the management of antiplatelet therapy. The role of hybrid CABG PCI compared with sole PCI and sole conven- tional CABG awaits the results of the ongoing observational study of hybrid coronary revascularization by the National Heart, Lung, and Blood Institute. 8.2. 