Secondary coronary revascularisation: an emerging issue

Area of Science:

• Cardiology
• Vascular Surgery
• Interventional Cardiology

Background:

• Coronary revascularisation is increasingly performed worldwide.
• Secondary coronary revascularisation is an unavoidable consequence of graft/stent failure and disease progression.
• Current management often treats revascularisation episodically, not as a continuous process.

Observation:

• Atherosclerosis progression, graft/stent failure, and patient factors increase the need for repeat procedures.
• Evidence-based knowledge on secondary revascularisation is fragmented across literature and guidelines.
• A dedicated category for secondary revascularisation is lacking, hindering implementation.

Findings:

• Lack of a unified approach leads to suboptimal patient care.
• Fragmented knowledge and expertise impede comprehensive management.
• Unilateral decision-making can occur due to siloed knowledge.

Implications:

• A multidisciplinary approach is essential for effective patient management.
• Establishing a critical mass of expertise is vital for advancing research.
• Enhanced knowledge sharing among cardiologists, interventionalists, and surgeons is imperative.
• Raising awareness among healthcare professionals is the first step toward process-oriented care.