Tag: CABG

Complete revascularisation – evidence in PCI

C Hamm (Bad Nauheim, Germany) reviews the evidence for the benefits of complete revascularisation in percutaneous coronary intervention.

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Total arterial revascularisation results

P Kolh (Leige, Belgium) considers the long-term results of arterial revascularisation, the SYNTAX trial and the 2010 European Revascularisation Guidelines.

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Hunt for the best ‘second’ conduit

D Taggart of John Radcliffe Hospital, Oxford looks at the evidence for alternative conduits as the second choice after the left internal mammary artery for coronary bypass grafting.

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Proximal LAD disease case based discussion

M Dweck (Edinburgh, UK) presents a case of isoated proximal LAD disease. G Laufer (Vienna, Austria) argues in favour of surgery, while C Hamm (Bad Nauheim, Germany) puts forward the case for PCI. P Kolh (Liege, Belgium) considers how the

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Graft flow assessment

V Zamvar (Edinburgh, UK) describes different techniques for assessing intra-operative graft flow.

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Complete revascularisation – evidence in CABG

P Kolh (Leige, Belgium) assesses the evidence for the importance of completeness of myocardial revascularisation in coronary bypass surgery.

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Cardiology view of off pump CABG

C Hamm (Bad Nauheim, Germany) gives a brief assessment of off pump surgery from a cardiologist’s viewpoint.

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Off pump CABG discussion

D Taggart (Oxford, UK) leads an audience discussion on the merits of off-pump coronary bypass surgery.

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Graft pharmacoprotection evidence

N Roberts (London, UK) reviews the evidence for aspirin, clopidogrel, statins and ACE-inhibitors in improving graft patency.

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Radial artery in CABG

D Taggart (Oxford, UK) gives a quick overview of the evidence for radial artery conduit patency rates.

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Revascularisation anatomy vs function

C Hamm (Bad Nauheim, Germany) explains the use of fractional flow reserve (FFR) in the assessment of coronary stenoses.

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Revascularisation completeness discussion

This is a panel and audience discussion on the importance of completeness of myocardial revascularisation, with particular emphasis on the use of fractional flow reserve (FFR).

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Off pump CABG – against

J Pepper (London, UK) presents evidence against the use of off-pump coronary bypass surgery.

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Off pump CABG – in favour

M S Uva (Lisbon, Portugal) argues in favour of off-pump coronary bypass surgery, reviewing the evidence from randomised controlled trials and meta-analyses.

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Endoscopic vein harvest is best

J Zacharias (Blackpool, UK) shows a video demonstration of the technique before reviewing the evidence for and against endoscopic vein harvest.

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Bilateral IMA evidence

D Taggart (Oxford, UK) reviews the evidence for bilateral internal mammary artery use in coronary bypass surgery.

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In favour of open vein harvest

D Souza (Örebro, Sweden) argues that an open vein harvest technique including peri-adventitial fat is best to optimise long-term patency.

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NSTEMI case based discussion

Prof G Laufer (Vienna, Austria) argues in favour of CABG in multivessel disease. P Kolh (Liege, Belgium) considers the case in the context of European guidelines. A discussion follows.

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Optimising vein graft outcomes

J Pepper (London, UK) considers the causes of vein graft occlusion before looking at possible ways to improve results.

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Surgical interventions for veins

G. Angelini (London, UK) describes surgical techniques to improve vein graft patency rates.

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Measuring graft flow

G Di Giammarco (Chieti, Italy) describes his experience in graft flow measurement to improve patency outcomes.

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Adequacy of IMA composite grafts

M Ruel (Ottawa, Canada) discusses whether single internal mammary artery grafts can adequately supply the heart.

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Intraoperative CABG graft and aortic assessment

S Rehman (Oxford, UK) discusses intra-operative imaging techniques in CABG surgery. S Westaby (Oxford, UK) argues that probing is sufficient to assess graft patency. R Haaverstad (Bergen, Norway) is in favour of graft assessment with transit time flow measurement and

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CABG for coronary artery disease

D Taggart (Oxford, UK) argues that CABG remains the best therapy for coronary artery disease in 2015.

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Shortening clamp time in combined surgery

R Capoun (Bristol, UK) reports on a multicentre randomised trial of shortening cardioplegic arrest time in combined cardiac surgery.

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ESC-EACTS 2010 revascularisation guidelines viewpoint & debate

D Taggart (Oxford, UK) gives his perspective on the 2010 European revascularisation guidelines, based on evidence from the literature. A discussion follows.

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ESC-EACTS 2010 revascularisation guidelines implementation

P Kolh (Liege, Belgium) describes the development of the 2010 European revascularisation guidelines. He emphasises the importance of the heart team and evidence-based protocols. He explores the indications for the different treatment options in stable disease, updating the guidelines with

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Antiplatelets – CABG

N Roberts (London, UK) gives an update on anti-platelet use in coronary bypass surgery patients.

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Ischaemic preconditioning ERICCA trial

D Hausenloy (London, UK) gives an update on the ERICCA trial of remote ischaemic preconditioning.

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Radial artery as the second conduit

D Taggart (Oxford, UK) reviews the evidence for using the radial artery as the first choice of second conduit in coronary bypass surgery.

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FREEDOM trial

D Hildick-Smith (Brighton, UK) discusses the FREEDOM trial and other diabetic data in revascularisation, from a cardiologist’s perspective.

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Revascularisation heart team information requirements

P Kolh (Leige, Belgium) promotes the value of the heart team and questions whom should be involved. He considers patient information, medical ethics, time and risk stratification.

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Effect of SYNTAX trial in Europe

P Kolh (Liege, Belgium) considers whether the SYNTAX trial has changed coronary artery disease practice in Europe. He reviews the results, examines the guidelines and emphasises the importance of risk models.

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Revascularisation heart team – surgeon’s view

D Taggart (Oxford, UK) emphasises the need for a heart team to ensure that patients receive the most appropriate guideline-driven interventions.

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Revascularisation stroke risk

N Howell (Birmingham, UK) looks at the timing of stroke after coronary surgery.

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UK database revascularisation data

B Bridgewater (Manchester, UK) explains the analysis of the UK database data and demonstrates visualisation of the data via the Blue Book Online. A comparison of single versus bilateral mammary usage in coronary revascularisation is then made.

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Revascularisation heart team – USA view

E Verrier (Washington, USA) discusses the revascularisation heart team from a USA perspective.

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Revascularisation heart team decision

H Luckraz (Wolverhampton, UK) assesses whether decisions made by the heart team are enacted.

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Revascularisation heart team – cardiologist’s view

M Norell (Wolverhampton, UK) talks about the role of the revascularisation multidisclipinary heart team from a cardiology viewpoint.

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SYNTAX trial 5 year results

D Taggart (Oxford, UK) presents the 5 year results of the SYNTAX trial, in the context of other evidence in coronary revascularisation.

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Antiplatelets – PLATO trial (Ticagrelor)

C McDonald (AstraZeneca) describes the PLATO trial of ticagrelor vs clopidogrel in acute coronary syndrome. The CABG sub-group results are presented.

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Vein graft stents

D Taggart (Oxford, UK) describes the VEST trial of external venous support for coronary bypass grafts.

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Off pump CABG should be abandoned

J Sabik (Cleveland, USA), as part of a debate, argues that off-pump CABG should be abandoned as our default procedure. He reviews results from the major trials as well as metaanalyses to support his view.

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Is bilateral IMA use the gold standard?

J Sabik (Cleveland, USA) considers the evidence for bilateral internal mammary artery usage in coronary bypass surgery. He uses data from the large Cleveland clinic registry to explore the importance of time, coronary vessel anastomosed, conduit used and patient factors

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Thoracoscopic IMA harvest

A de Souza (London, UK) describes his technique for endoscopic internal mammary artery harvest.

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SYNTAX trial influence in the USA

JF Sabik (Cleveland, USA) considers whether the SYNTAX trial has changed practice in the USA and, if not, why not? He reviews the trial design and results before looking at registry data to inform about current patterns of coronary artery

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MIDCAB procedure evolution

R Stanbridge (London, UK) describes the evolution of minimally invasive coronary surgery from his initial experience in 1995, and considers the results of the procedure.

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Graft pharmacoprotection USA view

T Sundt (Boston, USA) gives a brief overview of the evidence for various drugs which could be used to improve vein graft patency.

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Off-pump CABG anaesthetic viewpoint

C Palin (Oxford, UK), a cardiac anaesthetist, explains his view on how practice has become so polarised. This is followed by a panel and audience debate.

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Hybrid coronary revascularisation

G Angelini (Bristol, UK) explains the evolution and current status of hybrid coronary revascularisation.

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Off pump CABG is here to stay

M Lemma (Milan, Italy) puts forward the argument in favour of off-pump coronary bypass surgery.

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Recent advances in interventional cardiology

N Curzen (Southampton, UK) explains the importance of physiological ischaemia and FFR in deciding optimal management for coronary disease.

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Ultrasound to reduce CVA in off pump CABG

C Royse (Melbourne, Australia) explains why he believes that the key to reducing risk of stroke is aortic assessment.

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Venous External Scaffolding Technology (VEST) for veins

E Orion (Tel Aviv, Israel), the co-inventor of the device, looks at the evidence for using an external support to improve vein graft patency.

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One arterial graft is sufficient

G. Angelini (London, UK) considers the evidence for single versus multiple arterial grafts in coronary bypass surgery, looking to explain why saphenous vein remains the second conduit of choice in the majority of cases worldwide.

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Inflammation and vein graft remodelling

P Quax (Leiden, Netherlands) describes the basic science behind vein graft remodelling, considering what factors trigger the inflammatory response.

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Vein graft external stenting

D Taggart (Oxford, UK) looks at the evidence for external stenting of vein grafts to optimise long-term outcomes.

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Vein graft stem cell therapy

A. Newby (Bristol, UK) discusses the incidence and causes of vein graft failure. He considers options to improve outcomes, in particular the use of periadventitial human stem cells.

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Conduit alternatives

R Hasan (Manchester, UK) gives an overview of the alternative conduits for bypass grafting. A de Souza (London, UK) reviews to evidence for these conduits.

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BIMA evidence

D Taggart (Oxford, UK) argues in favour of using bilateral internal mammary arteries for surgical revascularisation.

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MIDCAB programme setup

E Akowuah (Middlesbrough, UK) shares his experience of setting up a minimally-invasive coronary surgery programme.

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Off-pump CABG data to inform practicing surgeons

D Taggart (Oxford, UK) undertakes a detailed exploration of the evidence for and against off-pump CABG.

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Radial artery conduit – USA viewpoint

T Sundt (Boston, USA) gives a North American view of radial artery use as a bypass conduit.

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Off-pump CABG database evidence

B Bridgewater (Manchester, UK) presents provisional analysis of off-pump vs on-pump CABG from the SCTS database.

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Radial artery conduit

B Fabri (Liverpool, UK) explores the role of the radial artery as a conduit for bypass grafting.

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Off-pump CABG future

D Glineur (Brussels, Belgium) discusses the off-pump CABG trials and argues for the use of bilateral internal mammary arteries as a composite Y-graft.

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SYNTAX 4 year results

D Taggart (Oxford, UK) presents pre-syntax evidence for CABG vs PCI, before analyzing the results of the SYNTAX trial at four years.

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Off-pump CABG surgical viewpoint

G Angelini (Bristol, UK) talks about surgical attitudes to evidence-based medicine, professional competition and lack of innovation.

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RIMA to LAD revascularisation

N Howell (Birmingham, UK) explores whether RIMA-LAD revascularisation is equivalent to LIMA-LAD.

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STITCH trial review

A Wechsler (Philadelphia, USA) reviews the surgical treatment for ischaemic heart failure (STITCH) trial. Problems with trial design, recruitment and results interpretation are highlighted.

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SCTS database evidence for BIMA

B Bridgewater (Manchester, UK) presents figures from the SCTS database comparing single versus bilateral mammary artery use in CABG.

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Revascularisation completeness summary

D Taggart (Oxford, UK) summarises the debate on the evidence for completeness of myocardial revascularisation.

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