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Oxford Textbook of Medicine (5 ed.)

Edited by David A. Warrell, Timothy M. Cox, John D. Firth

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Latest update

The November 2012 update sees updates to over 70 chapters, focusing on Neurology and Gastroenterology. This update also incorporates a selection of 29 Case Histories taken from related titles in the Oxford Case Histories series, linked to from related chapters. Each case includes several questions followed by detailed answers and discussion to enhance diagnostic and clinical understanding.

Neurology updates include substantial updates to key chapters and new material on a wide range of topics including spinal cord injury, autonomic nervous system disorders, and inherited neurodegenerative diseases. 

Gastroenterology updates include extensive revisions of key chapters on liver failure and acute pancreatitis and new material on a wide range of matters, ranging from the common to the rare: including surgical treatments for colonic diverticular disease, antibody tests for immune disorders, and a revised treatment algorithm for small bowel bacterial overgrowth.

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Publisher:
Oxford University Press
Print Publication Date:
May 2010
Print ISBN-13:
9780199204854
Published to Oxford Medicine:
May 2012
DOI:
10.1093/med/9780199204854.001.1

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Disclaimer

Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work. Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breastfeeding.

Contents

Coronary artery bypass surgery

Chapter:
Coronary artery bypass surgery
Author(s):

Graham Cooper

DOI:
10.1093/med/9780199204854.003.161307_update_001

November 28, 2012: This chapter has been re-evaluated and remains up-to-date. No changes have been necessary.

Update:

Reference to 2010 European guidelines on myocardial revascularization.

Updated on 25 May 2011. The previous version of this content can be found here.

Patients with left main-stem stenosis and three-vessel disease merit surgery for prognosis, regardless of symptom severity, especially if ventricular function is impaired. Coronary artery bypass is also an effective therapy for angina pectoris that is not controlled with medical treatment.

Despite a worsening risk profile in the population undergoing coronary artery bypass, operative mortality remains low. Ten years after operation, about 80% of patients are still alive and two-thirds are free of angina. Contemporary results are likely to be better than this due to increasing use of arteries instead of veins as bypass grafts, and improvements in secondary prevention.

The evidence shows that coronary artery bypass gives patients with coronary artery disease longer survival than percutaneous intervention, even with the use of drug-eluting stents.

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