Interventional cardiology versus minimally invasive cardiac surgery

Comparing interventional cardiology with minimally invasive cardiac surgery 1998 goes back to the early 80s when cardiologists treated coronary artery disease patients with balloon angioplasty under a permanent observation of cardiac surgeons who could offer to the patient the well established Conventional CABG, which already had proven to be safe, effective, durable, reproducible, and complete. At that time some critics predicted PTCA would remain the hobby of some cardiologists. During the last two decades, however, an explosive proliferation in the number of PTCA procedures has occurred, which soon exceed the number of CABG procedures. As technology has advanced and operator experience has increased, the application of PTCA has expanded from dilatation of simple, concentric single-vessel stenotic lesions to progressively more complex lesions in multivessel disease. Within the last 5 years the minimally invasive cardiac surgery has progressed, which allows the performance of even complex cardiac surgery through small incisions with (port-access technique) or without (MU)CAB technique cardiopulmonary bypass. The rationale of enthusiastic users of these new techniques leads to improved cosmetic results, less surgical trauma, decreased length of hospital stay, reduced cost, and comparable long-term results with respect to conventional CABG. Similar to the prediction about PTCA two decades ago, some critics say that minimally invasive cardiac surgery would remain the hobby of some cardiac surgeons. (C) 1999 Elsevier Science B.V. All rights reserved.