الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Cardiovascular disease and specifically coronary artery disease is the leading cause of death in men and women worldwide. (1)
With the revolution of medical services and great progress in diagnosis and treatment of coronary artery disease, coronary artery bypass graft surgery is one of the best forms of treatment and its short, medium, and long term results are well documented. (2)
The ultimate goal of CABG is, to improve the prognosis of symptoms,quality of life& survival in patients with CHD. (28)
The outcome for bypass surgery was better than that for PCI especially in multivessel coronary artery disease and in the presence of multiple risk factors (age, diabetes, respiratory diseases, peripheral artery disease, left main coronary artery disease, or diffuse coronary artery disease). (91)
There is a great progress in coronary artery bypass graft surgery trying to overcome its complications or need of revascularization. (11,12)
The use of bilateral IMA grafts reduces the requirements for repeat revascularization.(12,15,16)Improvements in anesthesia and monitoring techniques, myocardial protection by cardioplegia, and off-pump coronary artery bypass graft surgery (17-19) have resulted in improved outcomes.
coronary artery bypass graft surgery is endorsed by the excellent, well documented long term results generated with complete revascularization.(19)
The aim of this study was to describe actual reasons and clinical indications for referring patients with coronary artery disease for coronary artery bypass graft surgery in our society from the period between July to December 2010.
The study population consisted of 258 patients were diagnosed to have coronary artery disease. 70 patients admitted at Alexandria Univesity Hospital, 54 patients admitted at Medical Research Institute and 134 patients admitted at the International Cardiac Center (ICC).
All patients were subjected to history taking, clinical examination, ECG, echo cardiography,coronary angiography ,Syntax score,Euro score,STS score estimation then were diagnosed to have CHD and were referred for CABG
Analysis was performed to identify actual reasons for referring patients for CABG in our egyption society.
The results of this study showed:
Cardiovascular risk factors were smoking (53.5%), dyslipidemia (39.9%), diabetes (62%),hypertension (67.1%) & family history of ischemic heart disease (20.9%). History of previous MI (30.2%)&history of prior PCI (9.7%)
Patients classified according to presentation at time of admission into: (17.5 %) presented with stable angina and they classified according to CCS into (5.4 %) class II angina, (11.2 %) class III , (0.9 %) class IV & (46.5 %) presented with unstable angina.
(19.4 %) presented with STEMI , (11.7 %) presented by Non STEMI and (5%) presented with silent ischemia provoked by dyspna due to valvular heart disease .
As regards Euro Score points , patients were divided as: 15 (5.8%) patients had 0-2 points, 23 (8.9%) patients had 3-5 points, 30 (11.6%) patients had 6-8 points, 42 (16.3%) patients had 9-10 points, 53 (20.5%) patients had 11-13 points present in & 95 (36.9%) patients had > 13 points .
As regards STS score patients were divided as following: 34 (13.2%) patients had low STS score, 60(23.2%) patients had intermediat STS score, 164(63.6%) patients had high STS score.