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State-of-the-Art Coronary Artery Bypass Grafting: Patient Selection, Graft Selection, and Optimizing Outcomes

Mario F L Gaudino1, Cristiano Spadaccio2, David P Taggart3

  • 1Department of Cardiothoracic Surgery, Weill Cornell Medicine, NewYork-Presbyterian Hospital, 525 East 68th Street, New York, NY 10021, USA.

Interventional Cardiology Clinics
|March 6, 2019
PubMed

Insights

Coronary artery bypass grafting (CABG) is the primary treatment for multivessel disease, offering good long-term results. Optimizing outcomes involves patient selection, arterial grafts, and individualized surgical approaches.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Surgery Outcomes
  • Interventional Cardiology

Background:

  • Percutaneous coronary intervention (PCI) indications have expanded, with higher-risk patients undergoing procedures.
  • Coronary artery bypass grafting (CABG) remains the standard treatment for multivessel coronary artery disease.
  • CABG offers favorable long-term outcomes and low complication rates.

Purpose of the Study:

  • To summarize current evidence on CABG for multivessel disease.
  • To review patient selection, indications, and graft choices for CABG.
  • To discuss strategies for optimizing CABG outcomes.

Main Methods:

  • Review of current evidence and literature on coronary artery bypass grafting.
  • Analysis of patient selection criteria and surgical indications.
  • Evaluation of different grafting strategies, including arterial grafts.

Main Results:

  • Coronary artery bypass grafting (CABG) is the mainstay for multivessel disease, yielding good long-term outcomes.
  • Multiple arterial grafting, particularly with anaortic techniques, may offer superior long-term results.
  • Individualized surgical approaches based on patient characteristics and surgical team experience are crucial.

Conclusions:

  • Coronary artery bypass grafting (CABG) remains a highly effective treatment for multivessel coronary artery disease.
  • Optimizing CABG outcomes requires careful patient selection, appropriate graft choice, and tailored surgical techniques.
  • Further research into optimizing arterial grafting and anaortic techniques may enhance long-term results.

Keywords:
Coronary artery bypass graftingHybrid revascularizationInternal thoracic arteryPercutaneous coronary interventionRadial artery

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