Document Detail

Multiple extensive coronary artery stenting: does it compromise future surgical revascularization?
MedLine Citation:
PMID:  17921740     Owner:  NLM     Status:  MEDLINE    
PURPOSE OF REVIEW: In the era of percutaneous coronary intervention, surgeons are confronted with performing coronary artery bypass graft surgery on patients with previous balloon dilatation or stenting. This review evaluates the impact of previous percutaneous coronary intervention on patient survival and choice of optimal myocardial revascularization technique. RECENT FINDINGS: Aggressive atherosclerosis has been remarked in patients complicated with intrastent stenosis. Moreover, bypass grafting with venous grafts has shown an extremely high incidence of graft failure in the restenosis population due to limited nitric oxide (a natural vasodilator) production of venous grafts. The challenge is to achieve complete revascularization in an unfavourable setting (greater co-morbidities, complex coronary lesions) with a greater risk of graft occlusion. SUMMARY: The internal thoracic artery is the optimal graft for myocardial revascularization in patients with and without previous in-stent restenosis. Coronary artery reconstruction by exclusive internal thoracic artery grafting gives superior patency rates and clinical outcomes. It is the most appropriate approach for myocardial revascularization in these patients.
Nawwar Al-Attar; Patrick Nataf
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in cardiology     Volume:  22     ISSN:  0268-4705     ISO Abbreviation:  Curr. Opin. Cardiol.     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-10-08     Completed Date:  2008-01-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8608087     Medline TA:  Curr Opin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  529-33     Citation Subset:  IM    
Department of Cardiac Surgery, Bichat Hospital, Paris, France.
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MeSH Terms
Coronary Artery Disease / mortality,  surgery*,  therapy*
Coronary Restenosis / mortality,  surgery*
Coronary Vessels / surgery
Myocardial Revascularization* / mortality
Treatment Outcome

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