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Conventional cardiac surgery in patients with end-stage coronary artery disease: yesterday and today

Michal Szlapka1, Roland Hetzer2, Jürgen Ennker3

  • 1Department of Cardiac and Vascular Surgery, MediClin Heart Center Coswig, Coswig, Germany.

Cardiovascular Diagnosis and Therapy
|March 12, 2021
PubMed

Insights

Surgical options for end-stage coronary artery disease (CAD) and heart failure include bypass grafting, ventricle restoration, and transplantation. Coronary artery bypass grafting (CABG) is a key alternative when donors are scarce.

Area of Science:

  • Cardiovascular Surgery
  • Heart Failure Management
  • Coronary Artery Disease Treatment

Background:

  • End-stage coronary artery disease (CAD) often presents with heart failure, necessitating complex surgical interventions.
  • Traditional surgical approaches have evolved, offering a range of options beyond heart transplantation.

Purpose of the Study:

  • To provide an overview of current and evolving surgical practices for patients with end-stage CAD.
  • To highlight the role of coronary artery bypass grafting (CABG) and other surgical techniques.

Main Methods:

  • Review of contemporary surgical strategies for combined CAD and heart failure.
  • Discussion of coronary artery bypass grafting (CABG), surgical ventricle restoration (SVR), and mechanical circulatory support (MCS).

Main Results:

  • Coronary artery bypass grafting (CABG), with or without surgical ventricle restoration (SVR), remains a significant surgical option.
  • CABG serves as a viable alternative to heart transplantation due to donor limitations.
  • Mechanical circulatory support (MCS) offers salvage and reevaluation opportunities for non-surgical candidates.

Conclusions:

  • Surgical management of end-stage CAD is multifaceted, encompassing revascularization, restoration, transplantation, and mechanical support.
  • The choice of surgical therapy depends on patient selection, myocardial viability, and donor availability.

Keywords:
Coronary artery bypass grafting (CABG)end-stage coronary artery disease (CAD)heart transplantation ischemic cardiomyopathymyocardial viabilitysurgical ventricle restoration (SVR)

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