[Indications and limits of conventional revascularization methods in coronary heart disease]

Abstract

The number of cardiologic patients undergoing invasive diagnostic catheterization is rapidly increasing. Due to more liberal and extensive indications for invasive diagnosis patients in relatively unfavorable clinical condition (e.g., elderly patients with severe extracardial disease, patients status post CABG) are being catheterized and, if suitable and indicated, undergo revascularization procedures. With rapidly increasing procedural skill of cardiovascular surgeons and invasive cardiologists even high-risk patients with severe coronary artery disease or underlying illness, who were classically excluded from surgical or catheter-invasive revascularization, are now being treated more aggressively. The changing indications for diagnostic catheterization and significant changes in the different modes of revascularization--operative bypass-surgery or interventional procedures--have led to continuous changes in the differential indications for these invasive therapeutic strategies. This article reviews and discusses the currently accepted indications for surgical and interventional revascularization as well as the limitations of these procedures.