Seminars in Thoracic and Cardiovascular Surgery
Volume 21, Issue 3 , Pages 199-206, Autumn 2009

Surgical Therapy for Complex Coronary Artery Disease

  • Andrew W. ElBardissi, MD, MPH

      Affiliations

    • Division of Cardiac Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
    • ,
  • Jorge M. Balaguer, MD

      Affiliations

    • Department of Cardiac Surgery, The Vanderbilit Heart Institute, Nashville, Tennessee
    • ,
  • John G. Byrne, MD

      Affiliations

    • Department of Cardiac Surgery, The Vanderbilit Heart Institute, Nashville, Tennessee
    • ,
  • Sary A. Aranki, MD

      Affiliations

    • Division of Cardiac Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
    • Corresponding Author InformationAddress reprint requests to Sary A. Aranki, MD, Division of Cardiac Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115

Recent advances in medical therapy, percutaneous myocardial revascularization, and coronary artery bypass grafting have allowed patients to live longer without eliminating the underlying pathology of coronary artery disease. In this review the authors discuss surgical options, perioperative assessment, procedural details, and outcomes after repeated coronary artery bypass surgery and coronary endarterectomy, in patients with severe coronary artery disease that is not suited for further percutaneous coronary intervention. Furthermore, the authors also discuss the role of transmyocardial revascularization and protein/gene therapy in those extreme situations where complex coronary artery disease is no longer amenable to traditional surgical intervention.

Keywords: coronary artery disease, coronary endarterectomy, transmyocardial revascularization, gene therapy, protein therapy

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PII: S1043-0679(09)00089-6

doi:10.1053/j.semtcvs.2009.08.006

Seminars in Thoracic and Cardiovascular Surgery
Volume 21, Issue 3 , Pages 199-206, Autumn 2009

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