scholarly journals A meta-analysis of minimally invasive coronary artery bypass versus percutaneous coronary intervention with stenting for isolated left anterior descending artery disease is indispensable

2007 ◽  
Vol 134 (2) ◽  
pp. 548 ◽  
Author(s):  
Hisato Takagi ◽  
Toshiyuki Tanabashi ◽  
Norikazu Kawai ◽  
Takuya Umemoto
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Minimally Invasive ◽  
Coronary Artery Bypass ◽  
Meta Analysis ◽  
Artery Bypass ◽  
Coronary Intervention ◽  
Left Anterior Descending Artery ◽  
Percutaneous Coronary ◽  
Artery Disease

Long-Term Outcome of Patients Undergoing Minimally Invasive Direct Coronary Artery Bypass Surgery

2018 ◽  
Vol 13 (1) ◽  
pp. 23-28 ◽  
Author(s):  
Shakil Farid ◽  
Jason M. Ali ◽  
Victoria Stohlner ◽  
Ruhina Alam ◽  
Peter Schofield ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Minimally Invasive ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Coronary Intervention ◽  
Left Anterior Descending Artery ◽  
Percutaneous Coronary ◽  
Hybrid Revascularization

Objective The primary objective was to investigate the long-term survival of patients who underwent single-vessel coronary revascularization with minimally invasive direct coronary artery bypass surgery with or without hybrid revascularization. The secondary outcome measures were repeat revascularization either by coronary artery bypass grafting or by percutaneous coronary intervention and the incidence of myocardial infarction or recurrent angina. Methods This is a retrospective study of prospectively collected data of patients who underwent minimally invasive direct coronary artery bypass procedure in our center between January 2001 and December 2015. Procedures were performed either through small left anterolateral thoracotomy or lower midline sternotomy. Results A total of 182 patients were identified: 100 underwent minimally invasive direct coronary artery bypass to the left anterior descending artery and 82 underwent hybrid revascularization (percutaneous coronary intervention to coronary arteries other than the left anterior descending artery along with minimally invasive direct coronary artery bypass to the left anterior descending artery). The mean ± SD age was 62 ± 10.1 years. Preoperatively 82% were male, and 72.5% patients had good left ventricular function. The median follow-up period was 10.9 years. There was no inhospital or 30-day mortality. The 10-year actuarial survival was 84.8%. Freedom from repeat revascularization was 98.9% at 1 year and 89.9% at 10 years. At follow-up, freedom from myocardial infarction was 96.7% whereas freedom from angina was 92.9%. Conclusions Within the limitations imposed by retrospective analyses, our study demonstrates excellent long-term outcome in patients undergoing minimally invasive direct coronary artery bypass with or without hybrid revascularization. For isolated left anterior descending artery disease minimally invasive direct coronary artery bypass should be considered, whereas hybrid revascularization (percutaneous coronary intervention and minimally invasive direct coronary artery bypass) should be considered for multivessel disease.

Percutaneous Coronary Intervention with Stenting versus Coronary Artery Bypass Grafting in Stable Coronary Artery Disease

2021 ◽  
Author(s):  
Ian C. Glenn ◽  
Gabriele M. Iacona ◽  
Abeel A. Mangi
Keyword(s):  
Coronary Artery Disease ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Coronary Intervention ◽  
Bypass Grafting ◽  
Percutaneous Coronary ◽  
Artery Disease

AbstractThe debate over coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) with stent placement for the treatment of stable multivessel coronary artery disease (CAD) continues in spite of numerous studies investigating the issue. This paper reviews the most recent randomized control trials (RCT) and meta-analyses of pooled RCT data to help address this issue. General trends demonstrated that CABG was superior in all-cause mortality and fulfilling the need for repeat revascularization. These advantages tended to be more pronounced in multivessel CAD and diabetes, and less so in left main CAD. PCI showed a consistently lower rate of cerebrovascular events. CABG continues to offer significant advantages over PCI, even as drug-eluting stent technology continues to evolve. The ideal endpoint for comparing PCI and CABG remains to be determined. Furthermore, additional research is required to further refine patient selection criteria for each intervention.

Evidence basis for decision-making between coronary artery bypass grafting and percutaneous coronary intervention

2021 ◽  
pp. 79-96
Author(s):  
Vasim Farooq ◽  
John D. Puskas ◽  
Patrick W. Serruys ◽  
David P. Taggart
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Coronary Intervention ◽  
Vessel Disease ◽  
Percutaneous Coronary ◽  
Antidepressant Efficacy ◽  
Artery Disease ◽  
Low Incidence

Historically, the 15 randomized clinical trials comparing coronary artery bypass graft surgery and percutaneous coronary intervention for intervention in coronary artery disease have been criticized for profound selection bias (‘cherry-picking’ of patients). The stringent clinical and angiographic-based inclusion criteria led to only 2–12% of all screened patients actually being randomized in these trials, resulting in recruitment of mainly low-risk subjects with predominant one- or two-vessel disease (and a low incidence of three-vessel disease), preserved left ventricular ejection fraction, and a low incidence of diabetes. This highly selective selection practice echoes that of a review of 31 antidepressant efficacy trials in 2002, demonstrating that despite the large number of trials and participants, only a minority of patients treated for depression in routine clinical were eligible for inclusion because of a large number of exclusion criteria.

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