New approaches to the surgical therapy of atherosclerotic coronary artery disease

Fundamental changes in the therapy of atherosclerotic coronary artery disea se, in both technique and strategy, are occurring in the practice of cardia c surgery. New surgical approaches to coronary artery bypass grafting inclu de the use of "mini" incisions and off-bypass techniques as well as the mor e widespread use of arterial conduits. Furthermore, the treatment of adult heart disease, in particular coronary artery disease, may be entering a per iod of fundamental change with the advent of nongrafting techniques, such a s transmyocardial revascularization, therapeutic angiogenesis, and gene the rapy This article provides an overview of these new approaches, which invol ve either modifications of current coronary artery bypass grafting techniqu es or the novel use of biologic revascularization, (C) 1999 by Excerpta Med ico, Inc.