Beyond complete myocardial revascularization: is it important and does it matter?
Constructing more than one graft per coronary system (left anterior descending, circumflex, right) has been widely and enthusiastically practiced for many years because it was thought to confer long-term freedom from major adverse coronary events. In reality the medical and surgical literature do not document the importance of maximizing the number of coronary vessels bypassed beyond one per system. Published series exhibit great variation in patient cohort, length of follow-up and lack the whole gamut of clinical endpoints. None of the published series provide an analysis based on subset stratification according to detailed coronary vessel anatomopathologic inventory in relation to revascularization strategy.
Nathanson
Michael
M
Santa Clara Valley Medical Center, Division of Cardiothoracic Surgery, San Jose, CA 95128, USA. mnathanson@scvmc.org
Ihnken
Kai
K
D003327:Coronary Disease / Q000601:surgery; D003331:Coronary Vessels / Q000601:surgery; D006801:Humans; D009204:Myocardial Revascularization / Q000379:methods