Current practice of state-of-the-art surgical coronary revascularization

Stuart J. Head, Milan Milojevic, David P. Taggart, John D. Puskas

Research output: Contribution to journalArticlepeer-review

103 Scopus citations

Abstract

Coronary artery bypass grafting remains one of the most commonly performed major surgeries, with well-established symptomatic and prognostic benefits in patients with multivessel and left main coronary artery disease. This review summarizes current indications, contemporary practice, and outcomes of coronary artery bypass grafting. Despite an increasingly higher-risk profile of patients, outcomes have significantly improved over time, with significant reductions in operative mortality and perioperative complications. Five- and 10-year survival rates are ≈85% to 95% and 75%, respectively. A number of technical advances could further improve short- and long-term outcomes after coronary artery bypass grafting. Developments in off-pump and no-touch procedures; epiaortic scanning; conduit selection, including bilateral internal mammary artery and radial artery use; intraoperative graft assessment; minimally invasive procedures, including robotic-assisted surgery; and hybrid coronary revascularization are discussed.

Original languageEnglish
Pages (from-to)1331-1345
Number of pages15
JournalCirculation
Volume136
Issue number14
DOIs
StatePublished - 1 Oct 2017

Keywords

  • Coronary artery bypass
  • Grafts
  • Mammary arteries
  • Myocardial revascularization
  • Radial artery

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