Survival and post-operative outcomes
Coronary revascularization is employed in stable disease to reduce cardiovascular events, prevent emergency revascularization, and improve symptoms in disease refractory to medical management[10,13]. CABG is preferred over PCI for revascularization of extensive, high-complexity, or significant left main CAD[13]. In this population CABG has been proven to decrease all-cause mortality, reduce risk of late spontaneous MI, and lower likelihood of requiring repeat revascularization. Surgical intervention is likewise necessary for aortic stenosis. While survival is excellent during the asymptomatic phase, mortality spikes to >90% within two years of symptom onset[8]. In the United States, TAVR is approved for use in patients regardless of risk strata and has shown non-inferiority at all risk levels. In high-risk population, TAVR significantly lowers all-cause mortality and stroke rates when compared to SAVR[17]. When extensive CAD and severe AS exist concomitantly, treating one but not the other is associated with worse outcomes regardless of sequence of procedures, thus hybrid techniques are recommended[12,13].