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European Heart Journal Advance Access originally published online on November 25, 2005
European Heart Journal 2006 27(4):375-376; doi:10.1093/eurheartj/ehi669
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© The European Society of Cardiology 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

How to overcome difficulties in the evaluation of best possible decision-making in redo-revascularization?

Brigitte R. Osswald*

Department of Cardiac Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany

* Corresponding author. Tel: +49 6221 56 6111; fax: +49 6221 56 4046. E-mail address: brigitte_osswald@med.uni-heidelberg.de

This editorial refers to ‘Predictors of revascularization method and long-term outcome of percutaneous coronary intervention or repeat coronary bypass surgery in patients with multivessel coronary disease and previous coronary bypass surgery’{dagger} by S.J. Brener et al., on page 413

The first 10% of the full text of this article appears below.

The value of studies on coronary artery bypass grafting (CABG) vs. percutaneous coronary intervention (PCI) is predominantly influenced by three important aspects:

  1. Study design and statistical methodology are of crucial importance concerning validity and reliability of the obtained results.
  2. CABG, PCI, and supportive medical therapy vary by time. The influence of such developments on the outcome is difficult to evaluate because of the limited number of patients and the lack of long-term experience.
  3. The most intriguing problem in comparing treatment modalities for coronary artery disease (CAD), remains the variety of coronary status and patient characteristics. Neither a straightforward strategy for a precise description of the coronary status nor a sufficient characterization of the patient's status is currently available.

Only few studies on . . . [Full Text of this Article]

Study design and statistical methods

Procedural aspects

Completeness of revascularization
Appropriateness of current technology in retrospective studies
Supportive medical therapy
Comparability of the subsets of patients
The meaning of redo-procedures in terms of risk stratification
Anatomical appearance
Is redo-CABG superior to PCI in patients after CABG?

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Related articles in EHJ:

Predictors of revascularization method and long-term outcome of percutaneous coronary intervention or repeat coronary bypass surgery in patients with multivessel coronary disease and previous coronary bypass surgery
Sorin J. Brener, Bruce W. Lytle, Ivan P. Casserly, Stephen G. Ellis, Eric J. Topol, and Michael S. Lauer
EHJ 2006 27: 413-418. [Abstract] [Full Text]  



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