Prospective Evaluation for Hybrid Cardiac Procedures

Prior treatment

• Previous cardiac surgery of any kind
• Previous thoracic surgery involving the left pleural space (if a left thoracotomy approach is planned)
• Complicated or unsuccessful PCI within 30 days prior
• Any prior lung resection
• Pregnant at time of screening, or unwilling to use effective birth control measures while dual antiplatelet therapy is required.

Other illness

• End-stage renal disease on dialysis
• Extra-cardiac illness that is expected to limit survival to less then 5 years
• Allergy or hypersensitivity to any of the study drugs or devices used in protocol

Other

• Total occlusion (TIMI 0 or 1 flow) of the LM or LAD
• Cardiogenic shock at time of screening
• Patient unable to give informed consent or potentially noncompliant with the study protocol, in the judgement of the investigator

• Signed informed consent, inclusive of release of medical information
• Age ≥ 18 years
• CAD with indication for revascularization
• Coronary anatomy as follows:
  • Multivessel-CAD involving the left anterior descending (LAD) (proximal or mid) and/or the left main (LM) (ostial, mid-shaft or distal) with at least one further epicardial coronary artery requiring treatment (LCX or RCA), OR
  • Single vessel disease involving the LAD and a major diagonal, both requiring independent revascularization with at least one stent
• Severe aortic stenosis/insufficiency and/or mitral stenosis/insufficiency requiring surgery, with CAD (involving one or more vessels), suitable for PCI
• CAD with indication for revascularization with severe unilateral carotid stenosis (\>85%)
• Ability to tolerate, and no plans to interrupt dual antiplatelet therapy (DAPT) for:
  • At least 6 months in presentation was stable CAD,
  • At least 12 months if presentation was a biomarker-positive acute coronary syndrome (ACS)
• Willing to comply with the follow-up required by the protocol.