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THE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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I. CURRENT INDICATIONS FOR MYOCARDIAL REVASCULARIZATION  THE MULTIFOCAL ATHEROSCLEROTIC PATIENT
DIAGNOSIS AND MANAGEMENT IN 2003


The Journal of Cardiovascular Surgery 2003 Giugno;44(3):313-8

lingua: Inglese

Indications of coronary artery bypass graft in 2003

Aupart M. 1, Neville P. 1, Tahir A. 1, Axelroud S. 2, May M. A. 2, Sacher A. 2

1 Depart­ment of Tho­racic and Car­di­o­vas­cular Sur­gery Trous­seau Hos­pital and Rab­e­lais Uni­ver­sity Tours, ­France
2 Depart­ment of Anes­the­sio­logy Trous­seau Hos­pital and Rab­e­lais Uni­ver­sity Tours, ­France


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During the ­last 3 ­decades, cor­o­nary ­artery ­bypass ­grafting (­CABG) ­emerged, was devel­oped and has pro­gressed. Addi­tion­ally, ­recent sur­gical inno­va­tions ­have ­been intro­duced ­aimed at ­reducing the ­trauma ­without devi­ating ­from the effi­ciency of con­ven­tional pro­ce­dure. At the ­same ­time sig­nif­i­cant evo­lu­tion in pre­ven­tive, med­ical treat­ment and per­cut­aneous pro­ce­dures has ­been ­observed. The intro­duc­tion of new treat­ment ­has improved the ­result in med­i­cally ­treated ­patients. Per­cut­aneous pro­ce­dures ­emerged and ­were devel­oped. New tech­nol­o­gies and ­advances avail­able to adjunc­tive med­ical ther­a­pies ­have ­appeared and ­have ­impacted the effec­tive­ness ­initially estab­lished for per­cut­aneous cor­o­nary inter­ven­tion (PCI). ­Larger use of ­stent per­mits a sig­nif­i­cant ­decrease in resten­osis and the intro­duc­tion of ­coated ­stent ­will prob­ably ­improve the ­results. Indi­ca­tion is a ­moving ­field. Con­tin­uing improve­ment in med­ical treat­ment, tech­nical pro­ce­dure and devel­op­ment of ­less inva­sive sur­gery mod­i­fies the ­place of ­each treat­ment and con­tin­uing eval­u­a­tion and com­par­ison are nec­es­sary. Intro­duc­tion of new treat­ment, ­aimed at ­treating ­ischemic car­di­om­yo­pathy ­like trans­myo­car­dial revas­cu­lar­iza­tion, ­cell trans­plan­ta­tion or ­gene ­therapy ­will prob­ably ­modify indi­ca­tions in the ­future.

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