A Brief History of Coronary Revascularization Surgery

The quest to treat coronary artery disease, the leading cause of death in the United States and worldwide, is fascinating and continues to evolve. Advances in coronary angiography including physiologic tests of coronary function, have paved the way for a greater understanding and more precise application of revascularization techniques. Development and application of improved medical treatments, goal directed medical therapy, add valuable treatment options. As management options have progressed, several studies have emerged as foundational for societal guidelines and have provided valuable and rational approaches for treatment of coronary artery disease. While debates persist on the treatment of coronary artery disease, overall, there has been a shift in paradigm to a team approach with treatment options tailored to anatomy, physiology, and patient wishes. Percutaneous coronary intervention, coronary artery bypass graft, and goal directed medical treatment are now viewed as tools that can be used in either tandem or in combination. As technology progresses and our understanding of the complex pathophysiology of coronary artery disease improves, our approach to coronary revascularization and preservation of cardiac function will continue to evolve.