Marco Piciche
San Bortolo Hospital, Italy
Biography
Abstract
Coronary artery bypass grafting remains the gold standard for the treatment of patients with severe coronary disease. Although percutaneous coronary interventions are the first treatment for single or two vessels disease, when coronary disease involves three vessels, especially in diabetic patients, surgery remains the best option. Coronary artery bypass surgery is endorsed by the excellent, well-documented, long-term results that follow complete revascularization and the use of mammary artery grafts. However, there is an endless debate surrounding the clinical outcomes after on-pump versus off-pump coronary artery bypass surgery. The off-pump literature is divided into an early, enthusiastic phase with results favoring off-pump surgery, an intermediate phase with conflicting results, and a current phase, with publications on leading journals favoring on-pump surgery. Nowadays, most centers perform on pump surgery, limiting off-pump surgery to a single anastomosis on the left anterior descending artery in single vessel disease. Herein, an extensive review of surgical techniques in coronary surgery is presented.