What is the role of coronary artery bypass grafting (CABG) in the acute management of ST-elevation myocardial infarction (STEMI) (MI, heart attack)?

Updated: May 07, 2019
  • Author: A Maziar Zafari, MD, PhD, FACC, FAHA; Chief Editor: Eric H Yang, MD  more...
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Answer

Despite great improvement of intraoperative myocardial preservation, CABG has a limited role in the acute management of STEMI. However, CABG remains indicated for cardiogenic shock, failed PCI, high-risk anatomy, surgical repair of a mechanical complication of STEMI (eg, ventricular septal rupture, free-wall rupture, or severe mitral regurgitation from papillary muscle dysfunction or rupture). CABG is also the preferred revascularization strategy for patients with unprotected left main disease, but PCI with DES is a reasonable alternative treatment option in those with favorable anatomy and high surgical risk. [86]


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