A review of outcomes following coronary artery bypass grafting (CABG) must be studied in the context of changing patient risk profiles. While overall CABG volumes have declined in Western nations over the last decade, there has been an increase in the number of patients referred with prior percutaneous coronary intervention, and presenting with worse distal disease. The advent of extracorporeal life support and mechanical circulatory support has allowed extremely high-risk patients to proceed to CABG where risk would have been historically prohibitive. Clinical trial evidence strongly supports CABG over percutaneous coronary intervention in patients with severe multivessel coronary artery disease, diabetes, and low ejection fraction. Unprotected left main disease was not previously judged appropriate for percutaneous coronary intervention; recent trials suggest that percutaneous coronary intervention is non-inferior to CABG in low SYNTAX score patients with left main stenosis (SYNTAX score <22). As such, those currently referred to surgery will often have more complex coronary disease than previously.
INCOMPLETE REVASCULARIZATION IN PATIENTS REFERRED FOR CORONARY ARTERY BYPASS GRAFTING CORRELATES WITH HIGHER SYNTAX SCORE
