Outcome of Coronary Artery Bypass Grafting – Strategies for Improvement

Abstract

During recent years, new conceptual, technical and drug strategies have led to improved early and late outcomes after coronary artery bypass surgery. These new strategies can be divided into the following three groups: optimisation of pre-operative patient selection and indications for and timing of the operation; peri-procedural refinements, including new techniques and instruments to avoid extracorporeal circulation, reduce aortic manipulation and minimise surgical access; and improvements to post-operative care, such as fast-track protocols and long-term drug therapy. In summary, the wide range of the surgical armamentarium available today allows cardiovascular surgeons to adapt the surgical strategy to individual patients and the given clinical scenario. This article aims to describe clinical rationales for the adoption of new concepts, provide an introduction to technical details and discuss clinical study results where appropriate.