Ajay J. Kirtane and Jeffrey W. Moses
Despite being technically challenging and carrying a higher periprocedural risk, the performance of revascularization in patients who have heart failure of ischemic origin can provide substantial clinical benefits. Although several studies have demonstrated a benefit of the performance of coronary artery bypass grafting over percutaneous coronary intervention (PCI) among patients who have depressed ejection fraction undergoing re-vascularization, most of these studies were conducted during the balloon angioplasty era and before the widespread use of drug-eluting stents that have dramatically reduced the need for repeat revascularization among patients undergoing PCI. The use of lower profile intra-aortic balloon catheters and other novel cardiac support devices may extend the use of PCI and lower rates of periprocedural complications among this high-risk population.
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