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Updated: Dec 21, 2025
Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
Published on: March 27, 2018
[Current status and prospect of coronary artery bypass grafting]
1Department of Cardiovascular Surgery, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing First Hospital, Nanjing Cardiovascular Hospital, Nanjing 210006, China.
Insights
Coronary artery bypass grafting (CABG) offers relief for angina and prolongs life in coronary artery disease patients. Optimal graft selection and surgical techniques, alongside post-operative care, improve long-term outcomes.
Area of Science:
- Cardiovascular Surgery
- Cardiac Surgery
- Thoracic Surgery
Background:
- Coronary artery bypass grafting (CABG) is a primary intervention for myocardial ischemia due to coronary artery disease.
- While saphenous vein grafts are common, arterial grafts, particularly the left internal thoracic artery, are preferred for long-term patency, especially in younger patients.
Purpose of the Study:
- To review current practices and evidence in coronary artery bypass grafting.
- To highlight factors influencing short-term and long-term outcomes in CABG patients.
Main Methods:
- Review of clinical practices and literature regarding CABG.
- Discussion of graft selection (saphenous vein vs. arterial grafts).
- Comparison of on-pump vs. off-pump and minimally invasive CABG approaches.
Main Results:
- Left internal thoracic artery is the "golden standard" for left anterior descending artery bypass.
- Arterial grafts are recommended for younger patients for improved long-term results.
- Off-pump and minimally invasive CABG are suitable for specific patient groups.
- Quality control, fast-track recovery, anti-platelet therapy, and secondary prevention enhance outcomes.
Conclusions:
- Optimizing graft choice and surgical technique is crucial for CABG success.
- Comprehensive perioperative management and long-term medical therapy are essential for maximizing graft patency and patient survival.
- Further prospective, multi-center randomized trials are needed to refine CABG clinical guidelines.
Abstract:
Coronary artery bypass grafting (CABG), the most common heart surgery in adults, has been used clinically to relieve the angina and prolong patients life due to myocardial ischemia from coronary artery disease. Although the saphenous vein is still commonly used graft, it is the "golden standard" to bypass the left anterior descending artery with left internal thoracic artery, and more arterial grafts are recommended in young patients for better long term results. On-pump coronary bypass can get the most complete myocardial revascularization but off-pump and minimal invasive coronary bypass are better reserved for the patients who are not-suitable for mid sternotomy and cardiopulmonary bypass. Good quality control with flow meter during surgery, fast track post-operatively, and intensive anti-platelets therapy along with second prevention may further decrease perioperative mortality and increase long term grafts patency rate. In the field of CABG, more prospective multi-center randomized trials are needed to provide more evidences for clinical questions in order to get the best short-term and long-term results.
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