Open heart surgery outperforms stents in patients with multivessel disease

Introduction:

Coronary Artery Bypass Grafting (CABG) is a type of surgical procedure that is done to restore normal blood to an obstructed coronary artery. This process is done in case of severe Coronary Heart Disease (CHD).

Coronary Heart Disease or CHD is the most common type of heart disease in which a substance called plaque (plak) builds up inside the arteries. Arteries supplies oxygen-rich blood to the heart which will be affected by the formation of Plaque. Plaque can be narrow and is made up of fat, cholesterol, calcium and other substances found in the blood which ultimately results in the blockage of the coronary arteries and slows the flow of blood to the heart muscle. If the blockage is severe, then it will cause angina (chest pain or discomfort that occurs if an area of your heart muscle when it does not get enough oxygen-rich blood) and heart attack.

Why CABG is important

Coronary artery bypass grafting (CABG) surgery may be the leading treatment choice for most patients with more than one blocked heart artery, according to new research. Analysts information demonstrate a noteworthy mortality advantage with CABG over percutaneous coronary intervention (PCI), and this advantage is reliable over essentially all major patient groups, recommending that CABG ought to be considered in broader patient populations, not fair in cases of patients with diabetes and left ventricular dysfunction, which is what is commonly practiced.

A new study found that from the last several years have seen a shift toward more PCI over CABG. While there may be valid reasons from the research data which show CABG outperforming PCI in almost every patient group, should push us to further, discuss all of the options."

PCI, often referred to as angioplasty, is a nonsurgical procedure that uses a thin, flexible catheter placed into an artery in the groin or arm. A balloon on the end of the catheter is positioned in the narrowed coronary artery and inflated to open up the blockage. A stent is a metal mesh tube that is left behind to help the artery from collapsing. Drugs attached to the stent, help to prevent the body from reacting to the stent and shutting down the artery again.

CABG, the most commonly performed heart operation in the United States is designed to bypass the blockages in the coronary arteries in order to create a new path for blood flow to the heart. The surgeon removes a healthy blood vessel, usually from the leg, arm, chest, or abdomen, and connects it to the other arteries (usually the aorta) in the heart. This enables blood flow to "bypass" or goes around the affected or blocked portion of the coronary artery.

The decision between open heart surgery and PCI for the treatment of patients with multiple narrowed arteries are not always straightforward, according to Researcher. Thus, these more complex treatment decisions should be made with the guidance of a heart care team.

"Both cardiac surgery and stenting have roles among patients with coronary artery disease," said Researcher. "Because of this, it is important to deliberate carefully with the help of a heart team. The team can ensure that a multidisciplinary approach is used when offering recommendations to patients and assisting them in making informed decisions."

A heart care team generally includes cardiothoracic surgeons and cardiologists. Other health care providers such as primary care physicians, physician assistants, nurse practitioners, imaging specialists, and anesthesiologists also may be part of the team. This approach is following more for the expertise of these advanced practice providers in an effort to improve the efficiency and advance the quality of care for patients.