Trends and strategies for myocardial revascularization.

Refinements in patient assessment, perioperative management and surgical technique have considerably improved the outcome and thus widened the indication for coronary bypass surgery. General indications for CABG surgery include left main stem stenosis or involvement of the LAD. Currently, there is no optimal technique or management, rather an individualized strategy considering the individual findings and risks. However, the trend points toward a wider use of arterial conduits and avoidance of proximal anastomoses. Recently evolving strategies including minimal invasive surgery and transmyocardial laser revascularization may indicate the beginning of a new era and show that coronary bypass grafting is still an evolving field for cardiac surgeons.