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Best way to revascularize patients with main stem and three-vessel lesions. Patients should be operated!

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Abstract

Despite established guidelines for the treatment of coronary artery disease (CAD) by either coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI), everyday clinical practice has proven to differ substantially with even the most complex coronary lesions being targeted by PCI today. However, an abundancy of clinical trials, both observational and randomized has proven the superiority of coronary surgery over PCI in almost every type of multivessel or left main CAD in symptomatic patients. This holds true also for ‘hard’ endpoints like cardiac death or myocardial infarction as recently demonstrated by the landmark SYNTAX trial. These results have lead to the wording of appropriateness criteria, which integrate current guidelines, evidence from clinical trials and interdisciplinary expert opinion and which express essentially the same message as the SYNTAX trial: “CABG remains the standard of care for patients with three-vessel or left main coronary artery disease” (Serruys et al. in N Engl J Med 360:961–972, 2009).

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Authors and Affiliations

  1. Department of Cardiovascular Surgery, University Heart Center Hamburg, University Medical Center Hamburg Eppendorf, Martinistr. 52, 20246, Hamburg, Germany

    H. Reichenspurner & L. Conradi

  2. Department of Cardiac and Vascular Surgery, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany

    J. Cremer

  3. Department of Cardiac Surgery, Heart Center Leipzig, University of Leipzig, Leipzig, Germany

    F. W. Mohr

Authors
  1. H. Reichenspurner
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  2. L. Conradi
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  3. J. Cremer
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  4. F. W. Mohr
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Correspondence to H. Reichenspurner.

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Reichenspurner, H., Conradi, L., Cremer, J. et al. Best way to revascularize patients with main stem and three-vessel lesions. Patients should be operated!. Clin Res Cardiol 99, 541–544 (2010). https://doi.org/10.1007/s00392-010-0190-2

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  • DOI: https://doi.org/10.1007/s00392-010-0190-2

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