CABG is the Best Therapy for Coronary Artery Disease

Yes CABG is superior to PCI in all subgroups of patients with multivessel cornary artery disease and propably cheaper. If the money factor is removed, then I gues more and more patients will be sent for surgical revascularization.

CABG is superior in management of all kinds of pathology in CAD. More and more cases that needs endarterectomy are being seen these days. LIMA to LAD is still the best. PCI is not doing more but rather less in the management.

Thanks for this clear demonstration of long-term superiority of CABG over PCI in MVD. The only alleged disadvantage of surgery remains to be the higher rate of stroke which can easily be overcome by off-pump bypass technique and more use of LİMA-T-grafts and aortic no touch technique.

Congratulations David, It was a very good analysis. Now is our job to proliferate and support all this valuable data and research done. Teaching and supporting corornary surgical techniques should be our responsibility to make it mandatory and instructive. Most of the coronary interventions done through surgical procedures today are very invasive,most performed by touching the aorta. In order to decrease the incidence of stroke we need to emphasize the use of OFF PUMP with different conduits, away from touching the aorta and without sacrificing the quality of the surgical procedure.  Today grafting is performed by using the Saphenous Vein in more than 80% of the cases; we should comeete in teaching the SV management as well. In patients with one vessel disease and proximal LAD we need to teach more extensevely the MIDCAB and MINI OPCAB surgical Techniques to be competitive and less invasive and traumatic; with two vessels and proximal LAD many of these patients in general are good candidates for Hybrid Technique procedures, LIMA to LAD first and stenting after.  The evolution of the Surgical revascularization technique as an Hybrid procedure could demonstrate the future for the best treatments.