OBJECTIVE To assess whether revascularisation that is considered to be clinically appropriate is also cost effective. DESIGN Prospective observational study comparing cost effectiveness of coronary artery bypass grafting, percutaneous coronary intervention, or medical management within groups of patients rated as appropriate for revascularisation. SETTING Three tertiary care centres in Lond...

OBJECTIVE Preoperative use of clopidogrel increases the risk of bleeding, but its postoperative use has not been studied. We studied early postoperative clopidogrel use in on-pump and off-pump coronary artery bypass grafting. METHODS Data were obtained from the University HealthSystem Consortium database. We conducted a retrospective analysis of data of 15,067 adults who had coronary artery b...

BACKGROUND The right gastroepiploic artery is commonly used in coronary artery bypass grafting. Appropriate strategies are required when performing upper abdominal surgeries after the right gastroepiploic artery has been used in coronary artery bypass grafting because compressing or injuring the graft may cause myocardial ischemia and fatal arrhythmias. To our knowledge, this is the first repor...

Surgical treatment of simultaneous coronary and carotid disease is still controversial, because of the high risk of morbidity and mortality after combined or staged carotid artery endoarterectomy and the coronary artery bypass grafting approach. We report the first 10 patients with concomitant coronary and carotid disease successfully treated with an alternative strategy consisting of simultane...

OBJECTIVE To compare the clinical, angiographic, neurocognitive, and quality of life outcomes of off-pump coronary artery bypass surgery with conventional coronary artery bypass grafting surgery using cardiopulmonary bypass. DESIGN Randomised controlled clinical trial. SETTING Tertiary cardiothoracic centre in Middlesex, England. PARTICIPANTS 168 patients (27 women) requiring primary isol...

OBJECTIVE To compare cardiac troponin T release and lactate metabolism in coronary sinus and arterial blood during uncomplicated coronary grafting on the beating heart with conventional coronary grafting using cardiopulmonary bypass. DESIGN A prospective observational study with simultaneous sampling of coronary sinus and arterial blood: before and 1, 4, 10, and 20 minutes after reperfusion f...

E et al. Off-pump or on-pump coronary artery bypass grafting at 30 days. versus on-pump coronary artery bypass grafting for ischaemic heart disease. A meta-analysis of large randomized trials for mid-term major cardio-and cerebrovascular events following off-pump versus on-pump coronary artery bypass grafting. Long-term follow-up of morbidity and mortality after aortic valve replacement with a ...