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The top 10 messages of the 2018 ESC guidelines on myocardial revascularization

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1. The heart team approach has received a class 1C recommendation to identify the most optimal treatment strategy for patients with ischemic heart disease while taking the patients’ preferences into… Click to show full abstract

1. The heart team approach has received a class 1C recommendation to identify the most optimal treatment strategy for patients with ischemic heart disease while taking the patients’ preferences into account. This multidisciplinary heart team decision-making process is critical as interventional cardiologists, clinical cardiologists and cardiac surgeons are increasingly targeting the same patient population for medical treatment, percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). 2. Prior to myocardial revascularization prognostic and symptomatic benefits should be estimated in patients with stable angina or silent ischemia. Left main or proximal left anterior descending coronary artery stenoses >50%, 2 or 3-vessel disease with stenosis >50% with severely impaired left ventricular function, a large area of myocardial ischemia or a stenosis >50% of the last patent coronary artery are considered as prognostically relevant. Other hemodynamically significant coronary stenoses should be treated in the presence of limiting angina or angina equivalent, refractory to optimized medical treatment. 3. The synergy between percutaneous coronary intervention with TAXUS and cardiac surgery (SYN-

Keywords: 2018 esc; messages 2018; coronary artery; myocardial revascularization; top messages; revascularization

Journal Title: Wiener klinische Wochenschrift
Year Published: 2019

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