Coronary artery bypass surgery indications

Coronary Artery Bypass Surgery Microchapters
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Patient Information
Overview
Pathophysiology
Saphenous Vein Graft Disease
Other Non-Atherosclerotic Saphenous Vein Graft Diseases
Indications for CABG
Prognosis
Diagnosis
Imaging in the Patient Undergoing CABG
Chest X Ray
Angiography
CT Angiography
MRI Angiography
Trans-Esophageal Echocardiography
Treatment
Goals of Treatment
Perioperative Management
Perioperative Monitoring
Electrocardiographic Monitoring
Pulmonary Artery Catheterization
Central Nervous System Monitoring
Surgical Procedure
Anesthetic Considerations
Intervention in left main coronary artery disease
The Traditional Coronary Artery Bypass Grafting Procedure (Simplified)
Minimally Invasive CABG
Hybrid coronary revascularization
Conduits Used for Bypass
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Videos on Coronary Artery Bypass Surgery
Post-Operative Care and Complications
Pharmacotherapy in patients undergoing CABG CABG
Special Scenarios
Anomalous Coronary Arteries
COPD/Respiratory Insufficiency
Existing Renal Disease
Concomitant Valvular Disease
Previous Cardiac Surgery
Menopause
Carotid Disease evaluation before surgery
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-in-Chief: Cafer Zorkun, M.D., Ph.D. [2], Mohammed A. Sbeih, M.D. [3]

Indications for CABG

CABG is the preferred treatment with:

• Disease of the left main coronary artery (LMCA). LMCA disease is associated with sudden death; therefore, lesions of the LMCA are sometimes referred to as widow makers.
• Disease of all three coronary vessels (LAD, LCX and RCA).
• Diffuse disease not amendable to treatment with a PCI.
• CABG is the likely the preferred treatment with other high-risk patients such as those with severe ventricular dysfunction (i.e. low ejection fraction), or diabetes mellitus patients, particularly those with disease involving the left anterior descending artery.

Alternative treatments for coronary artery disease include:

• Medical management (statins, antihypertensives, smoking cessation, tight blood sugar control in diabetics).
• Percutaneous coronary intervention (PCI)-Both PCI and CABG are more effective than medical management at relieving symptoms, (e.g. angina, dyspnea, fatigue), but repeat procedures are required more frequently after PCI.