PMID: 9423056Feb 1, 1990Paper

The recent trend of coronary surgery

Rinshō Kyōbu Geka = Japanese Annals of Thoracic Surgery
K Hirata, T Ban

Abstract

As the use of PTCA (Percutaneous Transluminal Coronary Angioplasty) is progressively widespread, the indication of CABG (Coronary Artery Bypass Grafting) and its candidates are changing accordingly. At present the candidates for CABG have left main trunk disease or severe triple-vessel disease, which are difficult or too dangerous to undergo PTCA. We should also note the population of operative candidates is becoming gradually older than before. The results from CABG appear to be limited according to the random follow-up studies in Europe and United States. The recurrence of angina and myocardial infarction tends to happen after five years. Our follow-up study shows the same tendency as those studies abroad. In order to improve the long-term results of CABG, we recommend the use of arterial grafts such as internal mammary artery, opt to the complete revascularization, and follow the patients postoperatively maximum medical therapy. At the same time, we should stress the importance of deciding the best operative opportunity, and not hesitate to make the decision for reoperation if it became necessary. Older candidates have tendency to suffer from neurological or respiratory complications during the postoperative period. If the r...Continue Reading

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