Document Detail


Current status of coronary artery bypass grafting for coronary artery atherosclerosis.
MedLine Citation:
PMID:  3898429     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Coronary artery bypass grafting has now undergone 18 years of proven benefit in the treatment of myocardial ischemic disease. The technique of CABG has been further extended to other situations in which myocardial blood supply is threatened, such as cardiac trauma, aneurysms of coronary arteries, and congenital lesions. The emphasis in choosing CABG over medical therapy in 1985 should be preservation of myocardium at jeopardy of infarction as well as relief of angina. Proximal stenoses in vessels subserving viable muscle that is ischemic at rest or with minimal exercise should be treated with reperfusion by angioplasty or CABG to prevent further injury. After infarction occurs and ventricular function is impaired, CABG is also necessary to preserve remaining myocardium at jeopardy. Such an aggressive approach seems warranted with today's excellent surgical results. Long-term results have also improved, as more attention has been paid to saphenous vein graft preparation, use of mammary artery grafts, complete revascularization, use of antiplatelet agents, control of spasm, and identification of hypercoagulable states that may require sodium warfarin (Coumadin). Angioplasty of vein grafts and distal anastomoses also appears promising to help extend the results of initial CABG. Figure 1 is our recommended approach for the treatment of coronary atherosclerosis.
Authors:
C B Christian; J W Mack; L Wetstein
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  The Surgical clinics of North America     Volume:  65     ISSN:  0039-6109     ISO Abbreviation:  Surg. Clin. North Am.     Publication Date:  1985 Jun 
Date Detail:
Created Date:  1985-10-08     Completed Date:  1985-10-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0074243     Medline TA:  Surg Clin North Am     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  509-26     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Angina Pectoris / surgery
Angina, Unstable / surgery
Coronary Artery Bypass*
Coronary Disease / pathology,  surgery*
Coronary Vessels / pathology
Humans
Prognosis
Risk

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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