Key result
Evolving CABG techniques improve multivessel revascularization outcomes in increasingly older and comorbid patients.
This review provides an overview of the current state of the art in coronary artery bypass grafting, highlighting its long-term durability compared to percutaneous therapies for multivessel disease.
Hypothesis-generating for CABG in older comorbid patients; prospective trials needed to guide revascularization choices.
According to the World Health Organization report Global Burden of Disease 1 , ischemic heart disease is the number one cause of death nowadays. Approximately 25% of the population over 75 years suffers from symptoms of cardiovascular diseases. Coronary artery bypass grafting (CABG) has become one of the surgical procedures performed most often all over the world. CABG has faced an unprecedented challenge in recent times from percutaneous therapies, but many centres report a trend now for greater referral for surgery for multivessel disease compared with recent years. This is likely to be at least in part explained by a growing acceptance of the long-term durability of revascularisation by CABG, which contrasts with the higher requirements for reintervention after percutaneous therapies in randomised studies. 2 Since the first CABG procedure surgical technique, as well as pre- and postoperative care evolved. Patients undergoing CABG nowadays are generally older and suffer from signifcantly more comorbidities. Apart from that the choice of the right graft conduit has become an important question while novel techniques of graft handling and harvesting have been developed aiming to improve patency rates. 3 The aim of this article is to give a short overview on current state of the art of CABG surgery - summarizing the scientifc literature with inclusion of our own institutional experience.
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Laufer et al. (2013) conducted a review in Ischemic heart disease. Coronary artery bypass grafting (CABG) vs. Percutaneous therapies was evaluated. Coronary artery bypass grafting remains a durable revascularization strategy for multivessel disease, with evolving techniques improving outcomes in increasingly older and comorbid patients.
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