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The Coronary Stentectomy and Shifts in Coronary Artery Surgery: An Interview with John Puskas

Wednesday, January 31, 2024

At the 2023 EACTS Annual Meeting, CTSNet Editor in Chief Joel Dunning and CTSNet senior editors set out to interview the most knowledgable CT surgeons from around the world. Stay tuned for more interviews from the meeting.

Joel caught up with Professor John D. Puskas, Professor of Cardiovascular Surgery and Director of Surgical Coronary Revascularization at the Mount Sinai Icahn School of Medicine in New York, as he finished presenting during a 'CABG Academy' on the topic of "Full Metal Jackets: How I Do Coronary Stentectomy." Dr. Puskas stressed the importance of patient selection and surgeon experience in undertaking the coronary stentectomy, deemed "the next generation of coronary endarterectomy." He highlights the difference between these two procedures, when they are effective, tips and pitfalls, and their importance in a rapidly changing patient population.

Dr. Puskas goes on to describe related topics in treating coronary artery disease, including management of coronary aneurysms and anomalous origins. The recent debate around the ACC Guidelines and how it pertains to surgical treatment of coronary artery disease provides a point of reflection, where Dr. Puskas discusses the important, fundamental differences between PCI and CABG. He urges the surgical community to rally behind the "How" in undertaking necessary coronary artery disease surgical procedures.

The discussion concludes with a settlement on where this leads in the future of coronary artery surgery in treating complex coronary diseases, especially as it becomes the physiological norm in many populations.


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