PHYSICIANS DEDICATED TO the care of patients with cardiovascular disease face a daunting
task, given the constant evolution of data and guidelines. The American College of
Cardiology, American Heart Association, and Society for Cardiovascular Angiography
and Interventions (ACC/AHA/SCAI) released an updated clinical practice guideline for
coronary artery revascularization (CAR) in December 2021 to provide a foundation for
decision-making in the care of patients in need.
1
This current guideline is nearly all-encompassing on the topics of CAR and related
items; per decree of the guideline writing group, the updated guidelines are intended
to replace a myriad of several now-outdated guidelines, including the ACC/AHA 2011
guidelines on percutaneous coronary interventions (PCI) and coronary artery bypass
grafting (CABG), among others.
1
The breadth of the 2021 CAR guidelines is considerable; this manuscript offers a
focused review of the major updated guideline components targeted toward cardiothoracic
anesthesiologists and intensivists, aiming to provide a summary of the items that
are of particular importance to perioperative patient care. These guidelines, it should
be noted, are not without controversy; not all stakeholders in CAR have endorsed the
guidelines. A concise comment on the objections raised by cardiac surgeons also is
included.Key Words
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Published online: September 27, 2022
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