Review Article: Coronary Revascularization

Abstract

Coronary revascularization with prospects to improve both quality and duration of life is rapidly expanding and one of the most frequently used procedures in modern medical practice. Coronary artery by pass graft (CABG) is the most rewarding procedure for high risk patients with stable coronary syndrome (those with significant left main coronary artery disease (LMCA), LV dysfunction, three vessel disease (3VD) and those with proximal lesions of the left anterior descending artery (LAD) with percutaneous coronary intervention (PCI) using drug eluting stent [DES] as an alternative procedure. The current SYNRAX study is comparing CABG and DES in such groups of patients.
PCI is a life saving procedure in patients with acute ST elevation myocardial infarction (STEMI).
In other subsets of patients both procedures may be equally effective to improve the patient's symptoms, with PCI being less invasive and readily available.
There is a recent interest in hybrid procedures in multi vessel disease with minimally invasive surgery for the LAD and PCI for other lesions. The rapid developments in PCI, CABG and adjuvant medications make any recommendations and guidelines on the move and alert the practicing clinicians to maintain a breast of current literature and to perceive the change.


Keywords: Coronary artery bypass graft (CABG), percutaneous coronary intervention (PCI)

Sudan Journal of Medical Sciences Vol. 2 (4) 2007: pp. 277-280