Are percutaneous coronary interventions changing our coronary surgery practice?

Abstract

Aim: The aim of this retrospective study was to assess the impact of a growing percutaneous coronary intervention (PCI) program on our coronary artery bypass graft (CABG) practice. Method: The data were collected from 300 consecutive surgical patients from January 2000 (early series) and from a similar number from July 2008 (recent series). Results: Our recent series presented an increased risk (mean Parsonnet scores rose from 5.5 to 7.3, mean euroSCORE rose from 2.4 to 3.1). The mean age increased from 60.3 to 63.8 years, with the percentage of patients over 70 rising from 14.3 to 29.1%. The proportion of females increased from 15.1 to 18.6%. Mean number of vessels grafted diminished from 3.24 to 3.02 per case. Fewer coronary arteries over 3mm diameter were grafted and more advanced atheroma was encountered at the site of grafting in the recent series. Conclusion: The rise in PCI was associated with a smaller surgical population presenting an increased risk and challenge to the cardiac surgical team.