Gibbon Lecturer: Coronary bypass surgery is unrivaled as a lifesaver

Bruce W. Lytle, MD, FACS
Bruce W. Lytle, MD, FACS

Coronary bypass surgery has a unique distinction in the annals of medicine.

“There is more evidence—and there is more good evidence—that bypass surgery prolongs life than there is for any other procedure in the history of medicine or surgery,” said Bruce W. Lytle, MD, FACS, chairman of cardiovascular strategic development and planning for cardiovascular medicine and surgery, Baylor Scott & White The Heart Hospital – Plano, TX.

In the John H. Gibbon, Jr., Lecture, Dr. Lytle will discuss the pathophysiology of coronary artery disease (CAD) and the continued relevance of coronary bypass surgery in the prevention of CAD death. Coronary Bypass Surgery: An Operation Like No Other will be available on Monday, October 25, at 9:00 am Central Time.

Coronary bypass surgery is the most commonly performed operation in cardiac surgery and the only one shown to improve life expectancy, Dr. Lytle said. Yet a relatively small number of surgeons take on this procedure as their mission. He would like to see this change.

“The operation must be taken more seriously than it is both in terms of lowering the risk and academically,” Dr. Lytle said. “It is the center of cardiac surgery.”

Over time, bypass surgery protects against the progression of native vessel disease better than percutaneous coronary intervention (PCI), he noted.

“Coronary bypass surgery, because of the fundamental differences in the concept of the operation, prolongs life expectancy better than PCI, and the reason that it has been superior in all trials in the last 40 years is not because of stent failure, but because the anatomical result achieved with bypass surgery is different,” Dr. Lytle said.

Although agents such as aspirin and statins have proven effective in prolonging survival for many patients with CAD, the noninvasive approach of drug therapy has not been a complete game-changer. “The use of effective medications has made the risk from CAD less but has not eliminated it and has not changed the paradigm in terms of the logic of doing invasive treatments for patients with severe CAD,” Dr. Lytle said.

He also will discuss the benefits of complete revascularization and vessel grafting.

“Flow-limiting lesions that are not severe enough to cause ischemia at the time of [cardiac catheterization] are important in predicting survival, and, therefore, complete revascularization is important and the grafting of vessels with moderate obstructions is important,” Dr. Lytle said.

Dr. Lytle previously served as chairman of the Heart and Vascular Institute at Cleveland Clinic, OH. The heart program at Cleveland Clinic was ranked first in the nation for 20 consecutive years during his 38-year tenure there.

The John H. Gibbon, Jr., Lecture, established in 1971 to honor a pioneer in open-heart surgery, is sponsored by the American College of Surgeons Advisory Council for Cardiothoracic Surgery.

This lecture will be available to registered attendees for on-demand viewing for a full year following the Clinical Congress on the virtual meeting platform.