Key result
Coronary-artery bypass grafting was historically shown to be strikingly superior to medical treatment for obstructive left main coronary artery disease, which had a 5-year mortality approaching 60%.
This review discusses the evolution of treatment for left main coronary artery disease, highlighting the established historical superiority of CABG over early medical therapy.
Establishes CABG benchmark for left main disease; leaves open refinement versus modern PCI and medical therapy.
When coronary arteriography was developed in the early 1960s, the very high risk associated with obstructive left main coronary artery disease became evident; this risk was related to the large volume of myocardium supplied by this vessel. Among patients receiving the medical therapy available at the time, the 5-year mortality approached 60%, and the survivors usually had severe symptoms, including angina, heart failure, or both.1 Several years later, after coronary-artery bypass grafting (CABG) became available, two multicenter, randomized trials that compared medical treatment with surgical treatment showed that surgical treatment was strikingly superior.2,3 Since then, there has been general . . .
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Eugene Braunwald (2016) conducted an editorial in Obstructive left main coronary artery disease. Coronary-artery bypass grafting (CABG) vs. Medical treatment was evaluated on Mortality. Coronary-artery bypass grafting was historically shown to be strikingly superior to medical treatment for obstructive left main coronary artery disease, which had a 5-year mortality approaching 60%.
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