REVIEW  NOVELTIES IN CARDIAC SURGERY 

Minerva Cardioangiologica 2020 October;68(5):469-79

DOI: 10.23736/S0026-4725.20.05228-7

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Mapping decision making for bypass surgery in the era of interventional medicine: towards an integrative model of patient-centeredness

Milan MILOJEVIC ^{1, 2} ✉, Petar MILACIC ¹, Ivana PETROVIC ³, Milovan BOJIC ^{1, 3}, Aleksandar MILOJEVIC ⁴, Aleksandar NIKOLIC ⁵, Sigrid SANDNER ⁶, Miguel SOUSA-UVA ^{7, 8}

¹ Department of Cardiac Surgery and Cardiovascular Research, Dedinje Cardiovascular Institute, Belgrade, Serbia; ² Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands; ³ Department of Cardiothoracic Cardiology, Dedinje Cardiovascular Institute, Belgrade, Serbia; ⁴ Department of Cardiac Surgery, Clinical Center of Serbia, Belgrade, Serbia; ⁵ Department of Cardiac Surgery, Acibadem Sistina Hospital, Skopje, North Macedonia; ⁶ Department of Cardiac Surgery, Vienna General Hospital, Medical University of Vienna, Vienna, Austria; ⁷ Department of Cardiac Surgery, Hospital Santa Cruz, Lisbon, Portugal; ⁸ Department of Surgery and Physiology, Cardiovascular Research Center, Faculty of Medicine, Porto University, Porto, Portugal

This article reviews the context and evidence of recent myocardial revascularization trials on PCI versus CABG with particular emphasis on patient selection and treatment of surgical patients. Moreover, one of our intended purposes is to identify the values underpinning the integrated care model, which incorporates decision to proceed with surgical myocardial revascularization in conjunction with established pillars of the use of optimal surgical techniques, and aggressive risk-factor modification through guideline-directed pharmacological therapies and lifestyle modifications.

KEY WORDS: Coronary artery bypass; Percutaneous coronary intervention; Decision making; Evidence-based medicine; Patient centered care