TY - JOUR
T1 - Coronary artery bypass grafting
T2 - Part 2 - Optimizing outcomes and future prospects
AU - Head, Stuart J.
AU - Börgermann, Jochen
AU - Osnabrugge, Ruben L.J.
AU - Kieser, Teresa M.
AU - Falk, Volkmar
AU - Taggart, David P.
AU - Puskas, John D.
AU - Gummert, Jan F.
AU - Kappetein, Arie Pieter
PY - 2013/10/1
Y1 - 2013/10/1
N2 - Since first introduced in the mid-1960s, coronary artery bypass grafting (CABG) has become the standard of care for patients with coronary artery disease. Surprisingly, the fundamental surgical technique itself did not change much over time. Nevertheless, outcomes after CABG have dramatically improved over the first 50 years. Randomized trials comparing percutaneous coronary intervention (PCI) to CABG have shown converging outcomes for select patient populations, providing more evidence for wider use of PCI. It is increasingly important to focus on the optimization of the short- and long-term outcomes of CABG and to reduce the level of invasiveness of this procedure. This review provides an overview on how new techniques and widespread consideration of evolving strategies have the potential to optimize outcomes after CABG. Such developments include off-pump CABG, clampless/anaortic CABG, minimally invasive CABG with or without extending to hybrid procedures, arterial revascularization, endoscopic vein harvesting, intraprocedural epiaortic scanning, graft flow assessment, and improved secondary prevention measures. In addition, this review represents a framework for future studies by summarizing the areas that need more rigorous clinical (randomized) evaluation. Published on behalf of the European Society of Cardiology. All rights reserved.
AB - Since first introduced in the mid-1960s, coronary artery bypass grafting (CABG) has become the standard of care for patients with coronary artery disease. Surprisingly, the fundamental surgical technique itself did not change much over time. Nevertheless, outcomes after CABG have dramatically improved over the first 50 years. Randomized trials comparing percutaneous coronary intervention (PCI) to CABG have shown converging outcomes for select patient populations, providing more evidence for wider use of PCI. It is increasingly important to focus on the optimization of the short- and long-term outcomes of CABG and to reduce the level of invasiveness of this procedure. This review provides an overview on how new techniques and widespread consideration of evolving strategies have the potential to optimize outcomes after CABG. Such developments include off-pump CABG, clampless/anaortic CABG, minimally invasive CABG with or without extending to hybrid procedures, arterial revascularization, endoscopic vein harvesting, intraprocedural epiaortic scanning, graft flow assessment, and improved secondary prevention measures. In addition, this review represents a framework for future studies by summarizing the areas that need more rigorous clinical (randomized) evaluation. Published on behalf of the European Society of Cardiology. All rights reserved.
KW - Anaortic
KW - Arterial grafting
KW - Coronary artery bypass grafting
KW - Endoscopic vein harvesting
KW - Epiaortic scanning
KW - Graft flow measurement
KW - Guidelines
KW - Heart team
KW - Hybrid revascularization
KW - Minimally invasive
KW - Off-pump
KW - Secondary prevention
UR - https://www.scopus.com/pages/publications/84885355946
U2 - 10.1093/eurheartj/eht284
DO - 10.1093/eurheartj/eht284
M3 - Review article
C2 - 24086086
AN - SCOPUS:84885355946
SN - 0195-668X
VL - 34
SP - 2873
EP - 2886
JO - European Heart Journal
JF - European Heart Journal
IS - 37
ER -