Multivessel Minimally Invasive Coronary Bypass Grafting as HYBRID Revascularization Versus Conventional Off-pump Coronary Artery Bypass Grafting

Summary

The MICRA-HYBRID trial is a prospective, multicenter, randomized controlled study comparing multivessel hybrid coronary revascularization (HCR) as minimally invasive arterial bypass grafting to left-sided coronary targets (LAD and LCx) plus PCI of the RCA versus conventional off-pump coronary artery bypass grafting (OPCAB) via median sternotomy in patients with three-vessel coronary artery disease. The primary goal is to evaluate whether multivessel-HCR provides superior 30-day "textbook" clinical outcomes (mortality, MI, stroke, re-exploration for bleeding, and other complications) while improving perioperative recovery and long-term cardiovascular outcomes.

Conditions

• Coronary Artery Disease (CAD)
• Bypass, Cardiopulmonary
• Minimally Invasive Coronary Revascularization Surgery
• Off-pump Coronary Artery Bypass

Interventions

PROCEDURE

Multivessel Hybrid Coronary Revascularization

Multivessel-HCR consists of MICS revascularization of the left sided coronary vessels (LAD , Cx) combined with PCI for the RCA during the same admission or within 4 weeks postoperatively. Surgical revascularization is performed through MICS which consists of either robotically or non-robotically assisted thoracoscopic IMA harvesting followed by total arterial off-pump anastomosis of the grafts through a left anterior 3-5 cm mini-thoracotomy. PCI will be performed via radial or femoral access according to local routine and is restricted to the RCA.

PROCEDURE

Off-pump coronary arterial bypass grafting (OPCAB)

OPCAB will be performed as per clinical routine at each center through a median sternotomy. IMA harvesting (pedicled or skeletonised) follows each center's routine. An anaortic, total arterial strategy with a LIMA-LAD graft and complete revascularisation is obliged.

Sponsors & Collaborators

• Universitaire Ziekenhuizen KU Leuven

  collaborator OTHER

• Eindhoven University of Technology

  collaborator OTHER

• Catharina Ziekenhuis Eindhoven

  lead OTHER

Principal Investigators

• Ferdi Akca, MD, PhD · Catharina Ziekenhuis Eindhoven

• Wouter Oosterlinck, Prof. Dr. MD, PhD · Universitaire Ziekenhuizen KU Leuven

• Pim Tonino, Prof. Dr. MD, PhD · Catharina Ziekenhuis Eindhoven

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

85 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2026-04-01

Primary Completion

2029-05-01

Completion

2034-05-01

Countries

• Belgium
• Netherlands

Study Locations