Is There Still a Survival Advantage to Bypass Surgery Over Percutaneous Intervention in the Modern Era?

Area of Science:

• Cardiology
• Interventional Cardiology
• Vascular Medicine

Background:

• Coronary artery bypass grafting (CABG) was the traditional treatment for multi-vessel coronary artery disease (MVD).
• Percutaneous coronary intervention (PCI) has advanced, gaining popularity and guideline recommendations for MVD.
• PCI is now the most frequently performed therapeutic intervention in medicine.

Purpose of the Study:

• To review current data on treating complex coronary artery disease, including MVD.
• To focus on patients with diabetes mellitus and the role of risk stratification and Heart Team review.
• To discuss complete versus incomplete revascularization and functional lesion assessment.

Main Methods:

• Literature review of recent data on MVD treatment strategies.
• Analysis of percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG) outcomes.
• Discussion of risk stratification and functional assessment techniques.

Main Results:

• PCI is an effective and safe treatment option for selected MVD patients.
• Neither PCI nor CABG alone provides a universal solution for all MVD patients.
• The importance of Heart Team evaluation and risk stratification is highlighted.

Conclusions:

• PCI is a viable and increasingly utilized revascularization strategy for MVD.
• Patient selection, risk stratification, and Heart Team approach are crucial for optimal MVD management.
• A personalized approach considering both PCI and CABG is necessary for the diverse MVD patient population.