For patients undergoing myocardial revascularization surgery, endoscopic harvesting of saphenous veins in expert hands is similar to traditional methods in terms of events, according to this study presented at the American Heart Association (AHA) Congress and published simultaneously in the New England Journal of Medicine (NEJM). This study, called REGROUP, was able to demonstrate that...
Hopes were raised high by the ARTS study, when set to show the benefit of bilateral internal mammary arteries (BIMA) during coronary artery bypass graft surgery compared over the use of a single internal mammary artery (SIMA) at 10 year follow up, but only one sub-study was able to show an advantage over radial grafts....
Used to different extents according to institution, surgeon, and historical time, the radial artery graft is yet to prove whether it can improve the outcomes of myocardial revascularization surgery when added to a single or bilateral internal thoracic artery graft. The ART (Arterial Revascularization Trial) was designed to compare survival after bilateral vs. single left internal...
The use of both internal thoracic (mammary) arteries for myocardial revascularization surgery might improve long-term outcomes, compared with the use of a single internal thoracic artery. Patients scheduled for myocardial revascularization surgery (only multivessel procedures; combined valve procedures were excluded) were randomized to receive a single internal-thoracic-artery graft (internal thoracic artery for the anterior...
Most clinical trials have shown benefits of beta blockers after acute myocardial infraction, including patients with extensive AMI, and these were carried out in the era before AMI was diagnosed with biomarkers and prior to treatment with coronary angioplasty, use of antithrombotic agents and high intensity statins, and angiotensin-aldosterone system inhibitors. The aim of this...
The purpose of myocardial viability testing is to identify patients that might benefit from revascularization by diagnosing three types of myocardium: normal, viable or hibernating, and scarred (non-viable). Non-randomized studies have shown recovery of a viable ventricle after myocardial revascularization surgery (CABG) and improved survival. However, a sub-analysis of the main study on viability testing,...
The impact of diabetes on the development of cardiovascular disease is widely known, with a strong association with extensive and diffuse coronary artery disease. Decision-making regarding how to revascularize patients with multi-vessel disease is a complex process. In this context, coronary artery bypass grafting (CABG) has been recommended over percutaneous coronary intervention (PCI) based on...
Acute myocardial infarction (AMI) continues to be a clinically significant condition due to its association with morbidity and mortality after the initial event. Therefore, the prognostic stratification of these patients is of vital importance. One of the tools that have been used for several years for this purpose is the SYNTAX I (SS) and SYNTAX...
Chronic coronary syndrome (CCS) has been considered another comorbidity in previous studies, and there has been no significant reduction in cardiovascular mortality or myocardial infarction (MI) rates with revascularization through percutaneous coronary intervention (PCI) or myocardial revascularization surgery (MRS) compared with optimal medical treatment (OMT). One possible reason for the lack of benefit has been...
Aortic stenosis (AS) is a common condition that shares risk factors with coronary artery disease. Many patients can suffer from both diseases simultaneously, something that increases the risk of acute myocardial infarction in the presence of aortic stenosis. AS can cause ischemia even in the absence of coronary artery disease, due to ventricular hypertrophy, increased...