Edelman J James B, Wilson Michael K, Bannon Paul G, Vallely Michael P
Cardiothoracic Surgical Unit, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
ANZ J Surg. 2012 Nov;82(11):792-8. doi: 10.1111/j.1445-2197.2012.06262.x. Epub 2012 Sep 18.
Patterns of myocardial revascularization have changed significantly over the past decade. There has been a relative decrease of coronary artery bypass grafting (CABG) compared with percutaneous coronary intervention (PCI) and some patients are undergoing PCI for coronary lesions traditionally reserved for CABG. The mid- to long-term results of several trials comparing PCI with CABG have recently been published. For three-vessel disease, CABG is superior to PCI, with lower rates of major adverse cardiac events. PCI may be equivalent to CABG for three-vessel disease in the lowest disease complexity tercile (SYNTAX score <22; ∼20% of patients). This review focuses on the most recent evidence for myocardial revascularization in patients with multi-vessel and left main coronary artery disease.
