Preoperative Assessment for CABG/PCI
Since the introduction of coronary artery bypass grafting (CABG) surgery in 1964, and percutaneous coronary intervention (PCI) in 1977, ischemic heart disease has remained a persistent threat to the quality and quantity of life. Today, due to improvements in medical therapy, the advent of increasingly durable stenting technologies, and a movement toward the use of arterial grafts and minimally invasive surgical techniques, cardiologists and cardiac surgeons are better equipped to manage and intervene on coronary artery disease (CAD). Given the diversity of revascularization options, as well as the rapid evolution of revascularization strategies, a thorough preoperative assessment of each patient being considered for myocardial revascularization is essential. In this chapter, we review the current indications for surgical and percutaneous myocardial revascularization and offer a practical guide for the preoperative assessment of patients being considered for revascularization. Although this chapter will focus primarily on patients with stable ischemic heart disease, considerations for patients presenting with acute coronary syndrome (ACS) and other special circumstances are also discussed.
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