Kimmaliardjuk Donna May, Toeg Hadi, Glineur David, Sohmer Benjamin, Ruel Marc
aDivision of Cardiac Surgery bDivision of Cardiac Anaesthesia, University of Ottawa Heart Institute, Ottawa, Canada.
Curr Opin Cardiol. 2015 Nov;30(6):611-8. doi: 10.1097/HCO.0000000000000220.
Coronary artery bypass graft (CABG) surgery has evolved and become much safer since its inception. This article outlines recent strategies in optimizing CABG mortality.
Improving operative mortality around CABG relates to five components. These include the role of relevant quality indicators; improved CABG techniques, such as multiple arterial grafting with less manipulation of the aorta; improvements in cardiopulmonary bypass; refinements in cardiac anaesthesia along with postoperative care; and the development of centres of excellence.
The development of advanced surgical revascularization techniques raises the question as to whether CABG expertise should be considered a sub-specialty of cardiac surgery. An expert CABG surgeon should be able to appropriately utilize several different revascularization techniques to adjust the operation to the patient, rather than the contrary.
