Current Practice of State-of-the-Art Surgical Coronary Revascularization

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...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 2017-10, Vol.136 (14), p.1331-1345
Main Authors: Head, Stuart J, Milojevic, Milan, Taggart, David P, Puskas, John D
Format: Article
Language:English
Subjects:
Coronary Artery Bypass - methods
Coronary Artery Disease - surgery
Humans
Robotic Surgical Procedures - methods
Treatment Outcome
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Summary: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.
ISSN:0009-7322
1524-4539
DOI:10.1161/CIRCULATIONAHA.116.022572