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Cardiac bypass and valve surgery 

Cardiac bypass and valve surgery

Chapter:
Cardiac bypass and valve surgery
Author(s):

Graham Cooper

DOI:
10.1093/med/9780199204854.003.161307_update_002

Update:

New chapter including valve surgery and peroperative assessment of patients for cardiac surgery, includes content from retired Chapter 16.13.8.

Updated on 29 Oct 2015. The previous version of this content can be found here.
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date: 19 August 2017

Coronary artery bypass grafting (CABG)—the two main indications for are for relief of symptoms, usually angina and/or breathlessness, that persist even with optimal medical therapy (OMT), and/or prognosis. There is a prognostic benefit of CABG in patients with large volumes of ischaemia (i.e. affecting >12% of the ventricular mass), and the benefit of revascularization increases with increasing volumes of ischaemia. The overall mortality for elective CABG in the United Kingdom is around 1% and has continued to fall over the last decade despite an increasingly adverse risk profile of patients undergoing surgery. In randomized trials and large propensity-matched cohort registries CABG, in comparison to percutaneous coronary intervention (PCI) even with drug-eluting stents, has been shown to improve survival and to reduce the subsequent risk of myocardial infarction and recurrent angina. Approximately 80% of patients are alive a decade after surgery of whom around 70% are still free from angina....

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