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When does bypass surgery become necessary as treatment for CAD?

Discussion in 'Medical Students - MD' started by Smooth Operater, Mar 2, 2007.

  1. Smooth Operater

    Smooth Operater don't bug "operatEr"! 5+ Year Member

    May 22, 2004
    When does bypass surgery become necessary as treatment for coronary artery disease? Thanks!
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  3. Cards21aceking

    Cards21aceking 5+ Year Member

    Feb 27, 2007
    perhaps this would be better suited for the cardiology or internal medicine board, but i think the most straight forward answer is that a CABG (coronary artery bypass graft) is in order when there's a substantial blockage of the artery.

    Oftentimes, patients may receive a angioplasty (ballooning of the vessels) or a stent (spring-loaded meshwork that pushes built up plaque against the walls of the vessel) before having a CABG. An initial step in this entire process is often an angiogram, where the cardiologist will shoot dye through the blood stream and observe if blockages do occur, and if they do, to what extent.

    I'm pretty sure there's some specific criteria for stress tests and ejection fractions, but I dont know them off the top of my head.
  4. smq123

    smq123 John William Waterhouse Administrator Physician SDN Advisor 10+ Year Member

    Jan 9, 2006
    One criteria is blockage in multiple vessels. (I think the specific number is 3 vessels). In that case CABG is preferred over angioplasty. Also, if the patient has very poor L. ventricular function because of the MI.
  5. Tired

    Tired Fading away 7+ Year Member

    Dec 12, 2006
    Don't forget the diabetes research.

    Also, try reading a book or looking at eMedicine. Or ask your doctor, especially if this is a personal question.
  6. Seeing who it's coming from......I wouldn't doubt it......
  7. Critical Mass

    Critical Mass Guest

    Feb 23, 2007
    It's never necessary. Haven't you heard that invasive cards has taken away all of the business from CT surgery? :D
  8. Anka

    Anka Senior Member 7+ Year Member

    Aug 18, 2003
    The American Heart Association publishes guidelines on this topic. They change from time to time (and I believe a new revision is coming out soon given the data on late thrombosis with drug eluting stents). But, look up those guidelines. They are quite specific.

  9. pillowhead

    pillowhead Senior Member 10+ Year Member

    Oct 25, 2002
    3+ vessel disease
    left main disease
    diffuse disease not amenable to angioplasty

    (check out any step 2 stuff for this)

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