Coronary Artery Bypass Grafting (CABG) Flashcards

The SYNTAX score is used in coronary artery disease primarily to:

Answer: Quantify coronary anatomy complexity and guide CABG vs. PCI decision-making

The SYNTAX score grades coronary anatomy complexity; higher scores favor CABG over PCI due to better long-term survival outcomes with surgical revascularization.

Endarterectomy during CABG is performed when:

Answer: A coronary artery is diffusely diseased and unsuitable for standard anastomosis without plaque removal

Coronary endarterectomy removes obstructive plaque from a diffusely diseased vessel to create a suitable landing zone for the bypass anastomosis.

Radial artery grafts in CABG should be used to bypass coronary targets with:

Answer: High-grade stenosis (greater than 70%) to avoid competitive flow-related graft failure

Radial artery grafts are prone to spasm and competitive flow failure when bypassing mildly stenosed vessels, requiring targets with ≥70% stenosis for durable patency.

Emergency CABG is most commonly indicated after failed PCI in the setting of:

Answer: Acute coronary occlusion with hemodynamic compromise unresponsive to catheter-based intervention

Emergency surgical revascularization is indicated when PCI fails to restore flow and ongoing ischemia with hemodynamic instability persists, requiring immediate coronary bypass.

Long-term statin therapy after CABG is indicated primarily to:

Answer: Slow native coronary and vein graft atherosclerosis progression and reduce cardiovascular events

Statins reduce lipid-driven atherosclerosis in native coronaries and bypass grafts, cutting long-term MI risk and improving survival after CABG.

The internal mammary artery receives its blood supply primarily from the:

Answer: Subclavian artery

The internal mammary (internal thoracic) artery arises from the first portion of the subclavian artery bilaterally, making subclavian stenosis an important preoperative consideration.