Orthodox coronary artery bypass surgery: The gold standard in surgical coronary artery disease intervention

Background: Advances in technology have produced a plethora of means to perform coronary revascularisation either surgically (that is, off pump CABG, Heartport CABG) and/or percutaneously (that is, stenting, rotablation). When comparing the results obtained by these new technologies, too often reference is made to results from the CABG operation of previous eras. Before tried and tested procedures are superseded by new, radical ones, it is essential to establish what the contemporary results of the CABG operation are on an unselected, general patient population. Aim: To examine contemporary results of primary orthodox CABG surgery in an unselected patient population from an Australian teaching hospital. Method: This was a prospective study of all patients having primary CABG surgery from 1 January 1996 to 30 June 1998. Results: 1002 patients had CABG. The mean age was 63.1 years, 33% were aged more than 70 years. Perioperative AMI occurred in 0.2% and CVA in 0.7%. Operative mortality for urgent or elective CABG was 0.4%. At 12 months, freedom from a repeat revascularisation procedure was 97%. Conclusion: Contemporary CABG surgery is associated with a very low morbidity and mortality. This is the gold standard in surgical coronary artery disease intervention and forms the benchmark to which alternative treatment strategies must be compared.