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Evaluation of a Novel Laser-assisted Coronary Anastomotic Connector - the Trinity Clip - in a Porcine Off-pump Bypass Model
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Coronary artery bypass surgery vs coronary angioplasty: from antithesis to synthesis

A P Dimas1, B Healy

  • 1Department of Cardiology, Cleveland Clinic Foundation, Ohio 44195-5210.

European Heart Journal
|December 1, 1989
PubMed

Insights

Revascularization therapy, including coronary artery bypass graft surgery and percutaneous transluminal coronary angioplasty, improves coronary artery disease management. Ongoing trials compare these treatments for multivessel disease to optimize patient outcomes.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiovascular Surgery

Background:

  • Revascularization therapy has significantly advanced coronary artery disease (CAD) management over the past 20 years.
  • Coronary artery bypass graft (CABG) surgery is a proven treatment for alleviating symptoms, preventing myocardial infarction, and improving survival in moderate to severe CAD.
  • Percutaneous transluminal coronary angioplasty (PTCA) is increasingly used as an alternative, expanding to single-vessel, multivessel disease, and acute ischemic syndromes.

Purpose of the Study:

  • To evaluate the long-term results of percutaneous transluminal coronary angioplasty (PTCA) in patients with multivessel coronary artery disease.
  • To address concerns regarding procedure-related mortality and restenosis rates associated with PTCA.
  • To compare the efficacy and outcomes of PTCA versus coronary artery bypass graft (CABG) surgery in multivessel CAD.

Main Methods:

  • Review of existing randomized trials and clinical data on PTCA and CABG for coronary artery disease.
  • Analysis of ongoing randomized clinical trials (e.g., CABRI, RITA, GABI, EAST, BARI) comparing PTCA and CABG.
  • Assessment of angiographic success rates, long-term results, mortality, and restenosis rates.

Main Results:

  • Angiographic success rates for PTCA exceed 90% in properly selected cases.
  • Limited data exist on the long-term outcomes of PTCA for multivessel coronary artery disease.
  • Procedure-related mortality and restenosis remain significant concerns for PTCA.

Conclusions:

  • Ongoing randomized trials are crucial for comparing PTCA and CABG in multivessel coronary artery disease.
  • These studies will provide essential information to guide revascularization strategies for optimal patient benefit.
  • Further research is needed to fully elucidate the long-term efficacy and safety of PTCA compared to CABG.

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