Cardiothoracic Surgery Service
LAC+USC Medical Center Student Handout
Coronary Artery Disease
Coronary Artery Disease (CAD) is one of the leading causes of death in the US.
Approximately 250-300,000 coronary surgeries are performed in the US / year.
Approximately 250-300,000 Percutaneous Transluminal Coronary Angioplasties (PTCAs) are performed in the US / year.
Risk factors for developing coronary artery disease:
Differentiate between coronary atherosclerosis and ischemic coronary artery disease. Ischemic disease involves areas of myocardium at risk for a myocardial infarct because of a hemodynamically significant stenosis proximally. This gives classic signs of angina pectoris.
Indications for Coronary Artery Bypass Grafting (CABG):
Left Main coronary disease
multiple vessel disease with crescendo angina refractory to medication
high grade proximal LAD diseasepost-infarction angina
Poor control of hypertension, cholesterol, diabetes
Non-use of the IMA
30% of the patients that undergo CABG will need "something" else done in their lifetime--re-do CABG, PTCA, etc. The hope is that by the time a further intervention is necessary, technology will have advanced and the outcome will be better.