Document Detail


Clinical trials and graft patency data in coronary artery surgery--a 30-year perspective.
MedLine Citation:
PMID:  16352242     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
The treatment of coronary artery disease, initially by medical and surgical and subsequently using percutaneous interventions, has evolved rapidly over the last 50 years. Randomized controlled clinical trials and observational studies of large cohorts have been instrumental in the evolution of the current practice of coronary artery revascularisation. This paper traces some of the historic trials of medical versus surgical therapy, surgical versus percutaneous intervention and graft patency studies. Medical therapy and percutaneous intervention are now the primary therapeutic modalities. However, there was an early recurrence rate with percutaneous intervention which has decreased with the use of drug-eluting stents. Coronary artery bypass surgery remains a major option for treating advanced coronary artery disease. Furthermore, it remains the treatment of first choice in most patients with left main coronary artery disease and those with extensive three-vessel proximal coronary artery disease, especially when associated with poor left ventricular function. The choice of a coronary artery bypass conduit is of major importance in developing a single long-term strategy for the surgical treatment of coronary artery disease. Bilateral internal thoracic artery grafting is now accepted as the treatment of choice, although not universally practiced. The role of other arterial conduits is being defined.
Authors:
Brian F Buxton; John Fuller
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Heart, lung & circulation     Volume:  13 Suppl 3     ISSN:  1443-9506     ISO Abbreviation:  Heart Lung Circ     Publication Date:  2004  
Date Detail:
Created Date:  2005-12-14     Completed Date:  2009-12-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100963739     Medline TA:  Heart Lung Circ     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  S7-S12     Citation Subset:  -    
Affiliation:
Department of Cardiac Surgery, Austin Hospital, Melbourne, Vic., Australia. brian.buxton@austin.org.au
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