Marco Piciche

Marco Piciche

San Bortolo Hospital, Italy



Biography

Marco Picichè (MD, Ph.D.) graduated with a degree in medicine from the University of Florence in 1995 and completed his cardiac surgery residency at the Tor Vergata University of Rome in 2000, both summa cum laude. He has worked as an assistant at Saint Luc Hospital, Catholic University of Louvain, Brussels (1999–2001), as a clinic head/hospital assistant at the universities of Clermont-Ferrand (2003–2004) and Montpellier (2004–2007). He held regular teaching appointments at the university of Montpellier school of medicine, obtained certification by the French Board in cardiac surgery (Paris, 2007), earned his research master in surgical science (Paris, 2007). In Canada he authored a research project on ‘‘Noncoronary collateral circulation,’’ at Québec Heart & Lung Institute, Laval University. In September 2011 he received a doctor of philosophy (Ph.D.) in therapeutic innovations from Paris-Sud University. He is the Editor in Chief of the book : « Dawn and evolution of cardiac procedures : research avenues in cardiac surgery and interventional cardiology » (Springer-Verlag publishing house). Currently he is a consultant cardiac surgeon in Italy.

 

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.