Giant Leaps in Surgical Myocardial Revascularisation

Abstract

There have been dramatic advances in Coronary Artery Bypass graft surgery over the past 45 years. Coronary artery bypass grafting with saphenous vein grafts, was a highly reproducible procedure effective in alleviating angina. Its usefulness was compromised by myo proliferative change and atheromatous changes in the saphenous vein grafts resulting in reduced graft patency (50-60%) and survival (60-70%) at 10 years.Introduction of the left internal thoracic artery to the left anterior ascending artery was a significant advance resulting in less recurrent angina, fewer cardiac events improved patency (> 90%) and survival (80-90%) 10 years postoperatively. The left internal thoracic artery to t..