Different treatment options in chronic coronary artery disease

April 27, 2009

Sometimes cardiologists and cardiac surgeons can agree! There is often disagreement between the professions of cardiology and cardiac surgery about the proper therapy for coronary artery disease (CAD)—and this can harm the patient.

In the current edition of Deutsches Ärzteblatt International, an interdisciplinary team of authors consisting of cardiologists and cardiac surgeons provides answers to the question of when a bypass operation (ACB) and when percutaneous coronary intervention (PCI) is effective (Dtsch Arztebl Int 2009; 106(15): 253-61). Martin Russ, Jochen Cremer and coauthors show that ACB and PCI are of equivalent value and can be placed in a complementary treatment plan.

The authors not only consider the results of randomized controlled studies, but extend their overview to the analyses of registries, which provide complementary data.

Thus PCI or ACB is advisable in those patients who still suffer from angina pectoris under drug treatment or for whom relevant ischemia has been demonstrated by non-invasive methods. According to the authors, the main indication for aortocoronary bypass surgery is when the proportion of ischemic myocardia is at least 10%. A operation can greatly improve the symptoms in the intermediate and long term. Severe comorbidity, such as renal failure or chronic obstructive pulmonary disease, support the use of PCI rather than ACB.

In critical constellations, the decision about the procedure to be used should be shared by cardiologists and cardiac surgeons, who must consider the patient's expectations, as well as the advantages and disadvantages in the short and long term.

More information: www.aerzteblatt.de/v4/archiv/pdf.asp?id=64226

Source: Deutsches Aerzteblatt International

Explore further: Robot-assisted minimally-invasive CABG surgery

Related Stories

Robot-assisted minimally-invasive CABG surgery

April 7, 2008

Dr. Robert Poston is a pioneer in the use of robotics for minimally invasive cardiac surgery. He recently joined BMC as chief of cardiac surgery. With his arrival, BMC has become one of only one of 9 hospitals across the ...

Recommended for you

How the finch changes its tune

August 3, 2015

Like top musicians, songbirds train from a young age to weed out errors and trim variability from their songs, ultimately becoming consistent and reliable performers. But as with human musicians, even the best are not machines. ...

Cow embryos reveal new type of chromosome chimera

May 27, 2016

I've often wondered what happens between the time an egg is fertilized and the time the ball of cells that it becomes nestles into the uterine lining. It's a period that we know very little about, a black box of developmental ...

Shaving time to test antidotes for nerve agents

February 29, 2016

Imagine you wanted to know how much energy it took to bike up a mountain, but couldn't finish the ride to the peak yourself. So, to get the total energy required, you and a team of friends strap energy meters to your bikes ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.