02 Nov 09
Prophylactic pre-operative coronary revascularization: Is the phoenix awakening?
By G Landesberg, M Mosseri
Exactly 30 years ago, Hertzer et al. published the first in a series of reports on thousands of patients who underwent routine coronary angiography before major vascular surgery. Their landmark studies were the basis for our current recognition that vascular surgery patients have a high prevalence of significant coronary artery disease (CAD): 60% have 1 or more coronary arteries with >70% stenosis, 18% have severe triple-vessel disease, and 4% have left main disease. Subsequently, Hertzer et al. showed that selective pre-operative coronary artery bypass graft surgery (CABG) in patients with severe CAD lowered the perioperative and long-term mortality relative to patients with similar degrees of CAD not treated with CABG…..