CLINICAL INDICATIONS FOR MYOCARDIAL REVASCULARIZATION SURGERY

Abstract

Myocardial revascularization surgery (CABG) represents a crucial intervention in the treatment of ischemic heart disease, aiming to reestablish adequate blood flow to the heart muscle. The clinical indications for performing this procedure have been the subject of extensive study, since the effectiveness of CABG is intrinsically linked to appropriate patient selection. Several factors, such as the severity of coronary disease, the presence of comorbidities and the response to clinical treatment, influence the decisions of health professionals when recommending this surgery. In this context, a systematic literature review is necessary to consolidate and critically analyze the available scientific evidence on the clinical indications for CABG, helping to guide clinical practices and therapeutic decisions. Objective: The present study aims to carry out a systematic literature review to analyze and synthesize the available evidence on the clinical indications for myocardial revascularization surgery. We intend to critically examine studies published in the last 10 years in the PubMed, Scielo and Web of Science databases, with the aim of identifying consistent patterns and gaps in the existing literature. Methodology: The methodology adopted for this systematic review, aligned with PRISMA guidelines, included a search for articles in the last 10 years in the PubMed, Scielo and Web of Science databases. Using the descriptors "myocardial revascularization", "clinical indications", "coronary disease", "cardiac surgery" and "surgical treatment", the search aimed to identify original studies, systematic reviews and meta-analyses that investigated the clinical indications for revascularization surgery myocardium in adult patients. The inclusion criteria encompassed studies that specifically addressed indications for CABG, while the exclusion criteria considered studies in which CABG was not the main focus, publications unavailable in full text and articles that did not provide relevant data on the clinical indications in question. . Results: The analysis of the selected studies revealed a diversity of criteria used in clinical practice to indicate CABG. The main indications addressed included the extent and location of coronary lesions, the presence of comorbidities and inadequate response to clinical treatment. A tendency towards personalization of decisions was observed, taking into account the individual characteristics of each patient. Conclusion: The results of this systematic review highlight the complexity of clinical decisions related to myocardial revascularization surgery. The personalized approach, considering the specific characteristics of each patient, emerges as a crucial element in determining indications for CABG. However, the heterogeneity of clinical practices suggests the need for future research to standardize and improve patient selection, aiming to optimize clinical outcomes and the effectiveness of CABG.