Safety and Efficacy Study of Hybrid Revascularization in Multivessel Coronary Artery Disease

Inclusion Criteria: * Age 18 or more * Angiographically confirmed multivessel CAD with involved LAD and critical (\>70%)lesion in at least one (apart LAD) major epicardial vessel amenable to both PCI and CABG * Indication for revascularization based upon symptoms of angina and/or objective evidence of myocardial ischaemia * Patient is willing to comply with all follow-up visits * Patient signed an Informed Consent Exclusion Criteria: * Severe congestive heart failure (class III or IV according to NYHA, or pulmonary edema, cardiogenic shock) at the time of enrollment * Prior surgery with the opening of pericardium or pleura * Prior stroke (within 6 months)or more than 6 months if there are substantial neurological defects * Prior history of significant bleeding (within previous 6 months) that might be expected to occur during PCI/CABG related anticoagulation * One or more chronic total occlusions in major coronary territories * Left main stenosis (at least 50% diameter stenosis) * Acute ST-elevation MI within 72 hours prior to enrollment requiring revascularization * Planned simultaneous surgical procedure unrelated to coronary revascularization (e.g. valve repair/replacement, aneurysmectomy, carotid endarterectomy or carotid stenting) * Contraindication to either CABG, MIDCAB or PCI/DES because of a coexisting clinical condition * Significant leukopenia, neutropenia, thrombocytopenia, anemia, or known bleeding diathesis. * Intolerance or contraindication to aspirin or both clopidogrel and ticlopidine * Extra-cardiac illness that is expected to limit survival to less than 5 years e.g. oxygen-dependent chronic obstructive pulmonary disease, active hepatitis or significant hepatic failure, severe renal disease * Suspected pregnancy. A pregnancy test will be administered prerandomization to all women of child-bearing age * Concurrent enrollment in another clinical trial * Patient inaccessible for follow-up visits required by protocol