Current status and prospect of coronary artery bypass grafting

Abstract

Coronary artery bypass grafting (CABG), the most common heart surgery in adults, has been used clinically to relieve the angina and prolong patients life due to myocardial ischemia from coronary artery disease. Although the saphenous vein is still commonly used graft, it is the "golden standard" to bypass the left anterior descending artery with left internal thoracic artery, and more arterial grafts are recommended in young patients for better long term results. On-pump coronary bypass can get the most complete myocardial revascularization but off-pump and minimal invasive coronary bypass are better reserved for the patients who are not-suitable for mid sternotomy and cardiopulmonary bypass. Good quality control with flow meter during surgery, fast track post-operatively, and intensive anti-platelets therapy along with second prevention may further decrease perioperative mortality and increase long term grafts patency rate. In the field of CABG, more prospective multi-center randomized trials are needed to provide more evidences for clinical questions in order to get the best short-term and long-term results.