TREATMENT OPTIONS IN CORONARY ARTERY DISEASE
The treatment of coronary artery disease depends on the severity of the condition, the number and location of the arterial narrowings, and the overall health of the patient. The best treatment strategy is selected using scientific evidence, validated risk and anatomical scores, and through discussion within a multidisciplinary heart team, ensuring a personalized and safe approach.
CORONARY ARTERY BYPASS SURGERY
Coronary artery bypass surgery is performed by creating new pathways, or “bypasses,” using the patient’s own arteries or veins to route blood around blocked coronary arteries and restore adequate blood supply to the heart.
The operation can be performed through:
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Conventional sternotomy, with a longitudinal incision along the
breastbone
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Minimally invasive surgery (mini-thoracotomy) in selected cases,
using smaller incisions
Bypass surgery may be carried out:
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With cardiopulmonary bypass (heart–lung machine)
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Or off-pump, on a beating heart, without the use of the machine,
in specific situations
The choice of technique depends on the patient’s anatomy,
clinical condition and other parameters.
This technique was first successfully developed in the 1960s and has since become one of the most studied and reliable procedures in cardiac surgery. Over the decades, continuous improvements in surgical techniques, anesthesia, and postoperative care have significantly increased safety and long-term outcomes, making bypass surgery a cornerstone in the treatment of complex coronary artery disease.
Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014". WikiJournal of Medicine 1 (2).DOI:10.15347/wjm/2014.010. ISSN 2002-4436., CC BY 3.0 <https://creativecommons.org/licenses/by/3.0>, via Wikimedia Commons
ENDOVASCULAR PERCUTANEOUS TREATMENT
The endovascular approach is a minimally invasive procedure performed through the blood vessels. It consists of dilating the narrowed coronary artery with a balloon and, when needed, placing a stent to keep the artery open and improve blood flow to the heart muscle.This option is suitable for selected lesions and patients.
MEDICAL TREATMENT
In some selected patients, a conservative approach based on medication may be appropriate. Medical therapy aims to relieve symptoms, improve blood flow, and reduce the risk of disease progression and future cardiac events, often combined with lifestyle modifications.