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J Thorac Cardiovasc Surg 2009;138:276-277
© 2009 The American Association for Thoracic Surgery

Editorial

Detrimental effects of coronary stenting on subsequent coronary artery bypass surgery: Is there another flag on the field?

Harold L. Lazar, MD*

Department of Cardiothoracic Surgery, the Boston Medical Center, and the Boston University School of Medicine, Boston, Mass

Received for publication April 7, 2009; accepted for publication April 11, 2009.

* Address for reprints: Harold L. Lazar, MD, Department of Cardiothoracic Surgery, Boston Medical Center, 88 E Newton St, Boston, MA 02118. (Email: harold.lazar@bmc.org).

The first 20% of the full text of this article appears below.


See related article on page 316.

 

Twenty-five years ago, Claude Grondin, a pioneer in the development of coronary artery bypass grafting (CABG), wrote an editorial in this Journal entitled "Late Results of Coronary Artery Grafting: Is There a Flag on the Field?"1Go In that editorial, Grondin noted that long-term patencies of saphenous vein grafts were significantly reduced as a consequence of recurrent atherosclerotic disease. This observation heralded the emergence of alternative percutaneous methods to treat ischemic heart disease. The cardiac surgeon is now faced with an increasing number of patients with multivessel disease in whom previous percutaneous coronary interventions (PCIs) with coronary stents have already been performed before CABG. In this edition of the Journal, Tran and coworkers2Go now report that patients with diabetes mellitus who have undergone stenting before CABG face an increased risk of operative death, increased perioperative complications, and decreased long-term survival. Does coronary stenting predispose toward adverse outcomes when CABG is subsequently needed? Is there another flag on the field?

Previous studies have shown the superiority of CABG relative to PCI in patients with diabetes and multivessel disease.3Go With the advent of the drug-eluting stent (DES), it has been suggested that stents will supplant CABG and become the primary method . . . [Full Text of this Article]


Related Article

The effect of previous coronary artery stenting on short- and intermediate-term outcome after surgical revascularization in patients with diabetes mellitus
Henry A. Tran, Scott D. Barnett, Sharon L. Hunt, Andrew Chon, and Niv Ad
J. Thorac. Cardiovasc. Surg. 2009 138: 316-323. [Abstract] [Full Text] [PDF]



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