Coronary artery bypass surgery
For over five decades, coronary artery surgery has been shown to relieve angina and extend life expectancy in individuals with significant coronary artery disease. Pioneered in the 1960s, it has grown to become the most commonly performed and most intensively studied surgical procedure in the world, and remains the gold standard method for coronary revascularization, especially in patients with more severe disease. Although it is increasingly challenged by percutaneous techniques using stents, the last decade has witnessed a significant reduction in surgical mortality (currently <1% in elective patients) and morbidity despite being applied in an increasingly older and sicker population. The use of multiple arterial grafts, especially using both internal thoracic and radial arteries, has resulted in significant improvements in long-term patency and clinical outcomes. Other technical advances include beating heart (off-pump) surgery and minimally invasive techniques.