Abstract
Coronary artery bypass surgery (CABG) is an essential component of the treatment of coronary artery disease (CAD). Since the introduction of percutaneous coronary interventions (PCI), especially drug-eluting stents, the number of CABG in Germany has continuously decreased. So far, there have been no studies showing that elective PCI can improve survival or decrease the rate of new myocardial infarctions. The CABG is the only form of treatment, which can have such an impact; however, this effect is influenced by a number of factors and is predominantly notable in patients with complex CAD. This is why in the current guidelines, PCI and CABG are given equal recommendations for patients with less complex CAD (lower SYNTAX score), and why CABG is primarily recommended in patients with complex CAD (higher SYNTAX score). There were many interesting publications in 2017 regarding factors influencing the long-term results after CABG. These data support the following conclusions: 1. CABG in complex CAD might provide a survival benefit over PCI or medicinal treatment and remains the gold standard. 2. Complete arterial revascularization is associated with the best results. 3. Off-pump techniques may be superior to on-pump techniques, especially when using no-touch aorta techniques; however, the results seem to depend heavily on surgeons' skills. 4. Non-invasive coronary imaging using computed tomography (CT) scanning is gaining significance and might be the future of CAD diagnostics. It might also have a great influence in the process of decision making in the treatment of CAD.