Making your Decision of the Heart
The American College of Cardiology (ACC) and the American Heart
Association (AHA) develop and periodically revise guidelines based on
the latest and most comprehensive clinical studies of CABG and PCI in
CAD patients. These evidence-based guidelines describe for physicians
under what specific conditions CABG or PCI should be performed.
According to the ACC/AHA guidelines, the decision to treat with CABG or PCI should be made objectively based on the following:
- Medicine or PCI can treat patients with chronic stable (predictable) angina who have one-vessel or two-vessel CAD and no significant plaque in the left main or left anterior descending artery.
- CABG or PCI with stent placement may provide similar initial results in people with simple cases of multi-vessel disease, but not if the left main artery is affected by CAD.
- CABG provides best results for patients whose left main artery is blocked or those with multi-vessel disease that includes the left main artery.
- CABG surgery is recommended for patients who have diabetes, are of advanced age or have a condition where the function of the left ventricle of the heart is impaired.
The evidence-based guidelines consider factors such as type of angina,
level of ischemia, ventricular function, number of coronary vessels
diseased, and various other factors. To ensure you’re receiving the
right treatment, it’s essential that a multidisciplinary heart team
consisting of a cardiologist, interventional cardiologist and cardiac
surgeon review your case together prior to making a treatment
recommendation for you.
