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Managing Heart Failure Patients with Multivessel Disease - Coronary Artery Bypass Graft versus Percutaneous Coronary

John Pepper1

  • 1National Institute for Health Research, Royal Brompton Hospital, London, UK.

Cardiac Failure Review
|August 9, 2017
PubMed

Insights

Guideline-directed medical treatment is standard for heart failure with reduced ejection fraction. However, surgical revascularization may improve survival and quality of life in select patients with extensive coronary disease.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Heart Failure Research

Background:

  • Guideline-directed medical therapy is the cornerstone for heart failure with reduced ejection fraction (HFrEF).
  • Surgical revascularization presents a potential survival and quality-of-life benefit for HFrEF patients with significant coronary artery disease and left ventricular dysfunction.

Purpose of the Study:

  • To review the risks and benefits of surgical revascularization versus percutaneous coronary intervention for HFrEF patients with multivessel disease.
  • To discuss commonly considered surgical interventions including coronary artery bypass grafting (CABG), surgical ventricular reconstruction, and mitral valve surgery.

Main Methods:

  • Review of existing literature on surgical interventions for HFrEF.
  • Comparative analysis of coronary artery bypass graft (CABG) versus percutaneous coronary intervention (PCI) in HFrEF patients with multivessel disease.

Main Results:

  • Surgical revascularization, particularly CABG, may offer improved outcomes in carefully selected HFrEF patients.
  • The decision between CABG and PCI requires careful consideration of disease extent and patient-specific factors.

Conclusions:

  • For specific HFrEF patients with extensive coronary disease and left ventricular dysfunction, surgical revascularization can enhance survival and quality of life.
  • The review highlights the importance of individualized treatment strategies in managing complex HFrEF cases.

Keywords:
Coronary artery bypass graftheart failuremultivessel diseasepercutaneous coronary intervention

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