Midterm Follow-Up After Minimally Invasive Direct Coronary Artery Bypass Grafting Versus Percutaneous Coronary Intervention Techniques

2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease

“…Cohort studies and RCTs 412,1050,1062,1063,1065,1077,[1093][1094][1095] as well as collaborative analyses and meta-analyses 1080,1096 -1098 showed that PCI and CABG result in similar survival rates in these patients.…”

2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention

“…10 Experts have recommended immediate PCI for unprotected left main CAD in the setting of STEMI. 51 The impetus for such a strategy is greatest when left main CAD is the site of the culprit lesion, antegrade coronary flow is diminished (eg, TIMI flow grade 0, 1, or 2), the patient is hemodynamically unstable, and it is believed that PCI can be performed more quickly than CABG. When possible, the interventional cardiologist and cardiac surgeon should decide together on the optimal form of revascularization for these subjects, although it is recognized that these patients are usually critically ill and therefore not amenable to a prolonged deliberation or discussion of treatment options.…”

2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery

“…69,[72][73][74][75][76][77][78][79][80][81][82][83] A retrospective cohort study of 14 766 consecutive patients undergoing isolated CABG identified a mortality benefit (OR: 0.45) for off-pump CABG in patients with a predicted risk of mortality Ͼ2.5%, 82 but a subsequent randomized comparison of off-pump CABG to traditional on-pump CABG in 341 high-risk patients (a Euroscore Ͼ5) showed no difference in the composite endpoint of all-cause death, acute MI, stroke, or a required reintervention procedure. 78 An analysis of data from the New York State Cardiac Surgery Reporting system did not demonstrate a reduction in mortality rate with off-pump CABG in any patient subgroup, including the elderly (age Ͼ80 years) or those with cerebrovascular disease, azotemia, or an extensively calcified ascending aorta. 69 Despite these results, off-pump CABG is the preferred approach by some surgeons who have extensive experience with it and therefore are comfortable with its technical nuances.…”