Aortocoronary bypass grafting -

[ArchivalUser]

bill

Q) A 70-year-old woman is seeking a surgical opinion following her heart catheterization, which was performed because of exertional chest pain. Her pain is worsening. Which of the following statements is true concerning aortocoronary bypass grafting?

A. It is indicated for crescendo (preinfarction) angina.
B. It is indicated for congestive heart failure.
C. It is not indicated for chronic disabling angina.
D. It is associated with a 10% operative mortality.
E. It is only indicated if significant triple vessel disease is
documented angiographically.

Kindly substantiate your answers.

[ArchivalUser]

justME1

Hmm..I'll pick E...because bypass comes with its risks, usually requires re-do at 10+years and many cardiologists will now fix one or two vessel dx with caths...so most bypasses (at least at our hospital) are for critical 3vessel dx.

[ArchivalUser]

talli

"E" seems to be correct..what is the answer and what was its explanation?

[ArchivalUser]

aditi

I will go for A..opertaive mortality is less than 1%.And CABG can be done in pts. with severe three vessel disease and in those with left main stem artery disease.

[ArchivalUser]

ankur

A.Not a very clear cut q.In unstable angina,CABG will be used only if the pt is not stabilised on medical therapy.There is atrend to go in for early invasive procedures,but even then the choice between CABG and PTCA with stent will be decided by the results of angiography.

It is indicated for CHF only if the cause of CHF is CAD.

It is indicated for chronic disabling angina,not responding to medical therapy.

It is indicated in LAD artey occlusion of > 50%,so E is incorrect.Moreover,in triple vessel disease(if LAD is not involved to >50%),it is used only if EF is >50% or there has been aprevious transmural infarct.

[ArchivalUser]

bill

A is the right answer!