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Coronary artery bypass and valve surgery 

Coronary artery bypass and valve surgery
Chapter:
Coronary artery bypass and valve surgery
Author(s):

Rana Sayeed

, and David Taggart

DOI:
10.1093/med/9780198746690.003.0369
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date: 05 March 2021

The two main indications for coronary artery bypass grafting (CABG) are for relief of symptoms, usually angina and/or breathlessness, that persist even with optimal medical therapy, and/or prognosis. There is a prognostic benefit for CABG in patients with large volumes of ischaemia (i.e. affecting >12% of the ventricular myocardium), 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. Valve surgery is primarily performed for patients with severe valvular disease and symptoms. Indications also include deteriorating ventricular function and the requirement for coronary artery surgery in patients with coexistent valve disease. Mitral valve repair is a highly successful procedure in patients with non-rheumatic valvular regurgitation and is associated with an excellent long-term survival.

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