Physical Address
304 North Cardinal St.
Dorchester Center, MA 02124
Coronary Artery Bypass Grafting
Background
Cardiovascular disease is the leading cause of death in the United States. An American suffers from a myocardial infarction approximately every 40 seconds. On average, men are 65 years old and women are 72 years old at the time of the first myocardial infarction. The death rate for coronary artery disease (CAD) has decreased by 31.8% over the 10-year period from 2006 to 2016. This has been attributed to effective treatment and prevention, which includes coronary artery bypass grafting (CABG).
CABG is a surgical procedure to treat ischemic heart disease due to obstruction of the coronary arteries. The procedure involves redirecting blood flow around (or bypassing) an obstruction in a coronary artery using a vessel from an alternative location. Approximately 371,000 CABG procedures are performed annually in the United States.
How to Use It
The diagnosis of CAD is made using coronary angiography when a patient has a myocardial infarction or angina symptoms. Subsequently, most medical centers will employ a “heart team” approach in which the results of the angiography are discussed among the cardiologists and cardiothoracic surgeons. If a patient is deemed to be a CABG candidate, the patient will undergo the operation. CABG is performed with the intention to treat CAD that has already been diagnosed, and typically no further diagnostic evaluation is undertaken during the CABG procedure itself.
The choice to proceed with CABG versus percutaneous coronary intervention (PCI) is a clinical decision taking into account baseline patient characteristics, such as functional status along with the coronary anatomy (including the location and severity of the obstructing lesions), and the patient’s ability to tolerate and comply with the dual antiplatelet therapy required after PCI. In general, patients with diabetes mellitus and multivessel CAD undergo CABG. For patients with triple-vessel or complex CAD, the preferred treatment is also CABG. Patients who require dual antiplatelet agents for another indication or who are at high risk for surgery will typically undergo PCI. See Chapter 46: Percutaneous Coronary Intervention for more details about this procedure.
You're Reading a Preview
Become a Clinical Tree membership for Full access and enjoy Unlimited articles
If you are a member. Log in here