Much effort has been expended assessing the relative merits of percutaneous coronary intervention (PCI) and coronary artery bypass graft (CAGB) surgery. Much less energy has been directed towards understanding the potential of these two interventions for causing additional myocardial damage during the procedure and the means to avoid this injury.
This review examines the impact of myocardial injury in elective PCI and CABG, principles of myocardial protection, and their efficacy in current coronary revascularisation. The objective of every coronary revascularisation should be a technically perfect result without producing myocardial damage. A patent graft that perfuses an area of myocardium with numerous pockets of myocyte necrosis serves no useful purpose.