Cardiology Intervention

Paper Summary:

This paper examines the current debate among cardiologists and cardiac surgeons regarding the use of coronary artery bypass surgery (CABG) versus drug-eluting stents (DES). The author concludes that the research indicates that, even though cardiac surgeons have conducted many studies that appear to show the benefits of percutaneous coronary interventions (PCI) with accompanying DES, there are still very serious considerations to using these interventions in certain groups of patients, especially those with multivessel coronary artery disease. This paper recommends future research with multicenter trials comparing use of PCI with DES as compared to CABG in terms of both short-term and long-term benefits, mortality rates, revascularization rates and other benefits or complicating factors in order to establish or disavow the superiority of PCI with DES. Thirteen figures are included with the paper.

Table of Contents:
Abstract
Statement of Problem
Key Terms and Definitions
Background of Study
Unprotected Left Main Stenosis
Multivessel Coronary Artery Disease
Summary
Conclusion
Recommendations for Future Research

From the Paper:

"According to Gunn and Crossman other energy sources are also useful. Sonotherapy, or unltrasound may potential more as a treatment than as a facilitator 'for gene delivery and is 'benign' in its effect on healthy tissue." Photodynamic therapy, or the interacting of photosensitizing drugs, light and tissue oxygen, is under investigation and still only in very early development. Laser energy delivered "via a fine intracoronary wire, is used in a few centers to recanalize block arteries." Gunn and Crossman state that the role of percutaneous clinical "has extended to the point where up to 70% of patients treated have acute coronary syndromes.""

Sample of Sources Used:

• Gunn, J. and Crossman, D. (2003) New Development in Percutaneous Coronary Intervention. ABC of Interventional Cardiology. British Medical Journal 2003;327:150-153 19 July 2003. Online available at: http://www.bmj.com/cgi/content/full/327/7407/150
• Fleischmann, K.E. (2007) Stenting Rather Than Bypass for Multivessel Coronary Artery Disease. Journal Watch 6 Sept 2007. Online available at: http://general-medicine.jwatch.org/cgi/content/full/2001/504/1
• Srinivas, V.S. (2002) Contemporary Percutaneous Coronary Intervention Versus Balloon Angioplasty for Multivessel Coronary Artery Disease. 9 Sept 2002. Clinical Investigation and Reports. Circulation Journal 2002:106:1627. Online available at: http://www.circ.ahajournals.org/cgi/content/abstract/106/13/1627
• Hannan, E.L. et al (2005) Is CABG the Preferred Method of Revascularization in Multivessel Coronary Artery Disease? New Engalnd Journal of Medicine 2005;352(21):2174-83. Online available at: http://www.cmaj.ca/cgi/reprint/173/2/148.pdf
• Dzavik, Vladmir et al (2001) Long-Term Survival in 11,661 Patients with Multivessel Coronary Artery Disease in the Era of Stenting: A Report from the Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH) Investigators. American Heart Journal. 141(1)L119-126, 2001. Online available at: http://www.medscape.com/viewarticle/409253_1

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