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DOI: http://dx.doi.org/10.1093/eurheartj/ehq335 2433-2440 First published online: 14 October 2010

The first Joint Guidelines on myocardial revascularization

Cardiologists and surgeons have joined forces to write recommendations for coronary artery disease, where cases are becoming increasingly complex and both PCI and CABG are viable options

The Joint, European Society of Cardiology (ESC)/European Association for Cardio-Thoracic Surgery (EACTS) Guidelines on Myocardial Revascularization are the first guidelines that bring together both disciplines involved in coronary revascularization.

Recommendations on revascularization have been embedded in other ESC guidelines on stable angina, non-ST-segment elevation myocardial infarction (STEMI), and STEMI but never before have cardiologists and cardiovascular surgeons joined forces to write common guidelines.

Their work has been accomplished through the ESC/EACTS Task Force, chaired by Dr. William Wijns, MD, PhD, FESC, co-director of the Cardiovascular Centre in Aalst, Belgium, and Professor Philippe Kolh, MD, PhD, FESC, cardiovascular surgeon at the University Hospital of Liège and professor of physiology at the University of Liège, Belgium.

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William Wijns

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Philippe Kolh

The Task Force comprises equal numbers of surgeons, interventional cardiologists, and non-interventional cardiologists, and the costs of producing the Guidelines have been shared between the ESC and EACTS.

It was felt that a joint approach was needed because in many cases of coronary artery disease (CAD), both percutaneous coronary intervention (PCI) angioplasty and stenting, and coronary artery bypass graft are possible and can be justified. There are chapters in the Guidelines dealing with technical issues of these procedures, but what's novel is that the guidelines emphasize a multidisciplinary approach for deciding which procedure should be used.

That means bringing together the surgeons and interventional cardiologists who perform the procedures with general cardiologists, clinical cardiologists, and experts in prevention to look at the data and address the question of what's best for the patient ‘instead of having a turf battle type discussion’, says Wijns.

In particular, the Guidelines recommend setting up a ‘Heart Team’ made up …