HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): J. Scott Rankin Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Rankin, J. S. Articles by Harrell, F. E. Search for Related Content PubMed PubMed Citation Articles by Rankin, J. S. Articles by Harrell, F. E., Jr Related Collections Coronary disease Related Article

J Thorac Cardiovasc Surg 2006;131:944-948
© 2006 The American Association for Thoracic Surgery

Editorial

Measuring the therapeutic efficacy of coronary revascularization: Implications for future management

Centennial Medical Center, Vanderbilt University, Nashville, TN.

Received for publication November 23, 2005; revisions received December 28, 2005; accepted for publication December 30, 2005.

^_* Address for reprints: J. Scott Rankin, MD, Vanderbilt University, 2400 Patterson Street, Suite 103, Nashville, TN 37203. (Email: Jsrankinmd@cs.com).

The first 300 words of the full text of this article appear below.

"In certain cases of angina pectoris, when the mouth of the coronary arteries is calcified, it would be useful to establish a complementary circulation for the lower part of the arteries."

Alexis Carrell, 1910

The concept of coronary revascularization has existed for a century now, since Alexis Carrell's seminal experimental procedure, in which the left subclavian artery was suture-anastomosed to the circumflex coronary artery in the dog. ^1,2 The latter half of the century witnessed an explosion in techniques of coronary revascularization, both in cardiac surgery and interventional cardiology. With analysis of long-term outcomes, the clinical benefits of restoring coronary flow are now well-established, including improved quality of life and better long-term survival. In the past decade, however, multiple methods of coronary revascularization have emerged, creating confusion about the best technique in a given patient. Clinical approaches have been on a veritable roller coaster, leading to fractionation of therapeutic recommendations and controversy. As stated by Dr. John W. Kirklin in his 1972 Lewis A. Conner lecture before the American Heart Association ³ : "When [physicians] embark upon an intervention for their patient, they must do so with confidence and conviction if there is to be a high probability of success. But these very convictions can make the doctor guilty of premature conviction in evaluating procedures, unless he addresses this evaluation with the same seriousness and skill he uses in treating individual patients". With recent objective assessments, fairly uniform data now are emerging to guide decision-making, and relevant issues (and at least some answers) are becoming more consistent. The purpose of this editorial is to review briefly this new information, within the context of the article in this issue by Guru and associates, ⁴ and to present a viewpoint, based on the authors' interpretation of current data.

Very early after the clinical introduction of . . . [Full Text of this Article]

Related Article

How many arterial grafts are enough? A population-based study of midterm outcomes

Veena Guru, Stephen E. Fremes, and Jack V. Tu
J. Thorac. Cardiovasc. Surg. 2006 131: 1021-1028. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

				J. S. Rankin, R. H. Tuttle, A. S. Wechsler, T. L. Teichmann, D. D. Glower, and R. M. Califf Techniques and Benefits of Multiple Internal Mammary Artery Bypass at 20 Years of Follow-Up Ann. Thorac. Surg., March 1, 2007; 83(3): 1008 - 1015. [Abstract] [Full Text] [PDF]

				F. di Marco and G. Gerosa Percutaneous aortic valve replacement: Which patients are suitable for it? A quest for a controlled use J. Thorac. Cardiovasc. Surg., February 1, 2007; 133(2): 294 - 298. [Full Text] [PDF]