Coronary Artery Bypass Surgery in Acute Coronary Syndrome
Takase, S.; Yokoyama, H.
Kyobu Geka. Japanese Journal of Thoracic Surgery 68(8): 603-609
2015
ISSN/ISBN: 0021-5252 PMID: 26197901 Document Number: 679337
Acute coronary syndrome (ACS) is a critical situation. Early reperfusion is important to improve not only infarction size but also survival expectation rate. Percutaneous coronary intervention is in the 1st line in emergency situation to achieve earl perfusion. In this situation, urgent coronary artery bypass grafting (CABG) in ACS is indicated in patient with coronary anatomy not amenable to percutaneous transluminal coronary angioplasty (PCI) who have ongoing or recurrent ischemia, cardiogenic shock, severe heart failure, or other high-risk feature. When the patient does not require urgent treatment, CABG would be indicated according to the guideline for the management of stable angina as CABG is superior to PCI in regarding long-term survival and free from re-intervention. Even in any situations, decision making in heart team is important, especially in case of complicated and difficult situations.