ABSTRACT
The choice of treatment strategy from medical therapy, percutaneous transluminal coronary angioplasty [PTCA], and coronary artery grafting [CABG] greatly influences outcome of patients with chronic coronary artery disease. Recent randomized trials and registries information as to the judgment of optimal treatment strategy. These studies have shown that best outcome is likely when 1-or2-vessel disease without proximal left anterior descending artery [LAD] stenosis is treated medically. 2-vessel disease with proximal LAD stenosis or 3-vessel disease without proximal LAD stenosis is treated by PTCA or CABG. 3-vessel disease with proximal LAD stenosis or left coronary stenosis is treated by CABG. CABG is preferred to PTCA in diabetic patients and patients with decreased left ventricular function. Recent advances in the treatment coronary artery disease are also reviewed as they influence current treatment strategy
Subject(s)
Humans , Coronary Disease/therapy , Coronary Artery Bypass , Angioplasty, Balloon, Coronary , Diabetes Mellitus , Evidence-Based Medicine , Chronic DiseaseABSTRACT
The choice of treatment strategy from medical therapy, percutaneous transluminal coronary angioplasty [PTCA], and coronary artery bypass grafting [CABG] greatly influences outcome of patients with chronic coronary artery disease. Recent randomized trials and registries provide information as to the judgment of optimal treatment strategy. These studies have shown that best outcome is likely when 1-or2-vessel disease without proximal left anterior descending artery [LAD] stenosis is treated medically. 2-vessel disease with proximal LAD stenosis or 3-vessel disease without proximal LAD stenosis is treated by PTCA or CABG. 3-vessel disease with proximal LAD stenosis or left main coronary stenosis is treated by CABG. CABG is preferred to PTCA in diabetic patients and patients with decreased left ventricular function. Recent advances in the treatment of coronary artery disease are also reviewed as they influence current treatment strategy
Subject(s)
Humans , Myocardial Revascularization/adverse effects , Coronary Disease/therapy , Coronary Disease/surgery , Angioplasty, Balloon, Coronary , Coronary Artery Bypass , Evidence-Based Medicine , Diabetes MellitusABSTRACT
A 13-year-old girl with asplenia syndrome who previously had undergone left subclavian-to-pulmonary artery shunt after removal of a cavopulmonary shunt with interposition of a short segment of the left superior vena cava was admitted for congestive heart failure. Angiography revealed aneurysmal dilatation of the left superior vena cava. Percutaneous coil embolization of the shunt was successfully performed and the venous aneurysm was diminished. Interposition of a venous component in systemic-to-pulmonary artery shunt should be avoided even after removing a cavopulmonary shunt.