In the article by Zakkar et al, “Response to Weintraub and Garratt,” which appeared in the May 3, 2016 issue of the journal (Circulation. 2016;133:1826. DOI: 10.1161/CIR.0000000000000423), the first two sentences were incorrect and should read:
The article by Weintraub and Garratt includes the following key points: (1) the use of coronary artery bypass graft (CABG) to treat chronic total occlusions (CTOs) is limited; (2) the use of percutaneous coronary intervention (PCI) to treat CTOs is extensive; (3) CABG-CTOs can be justified in the setting of multivessel disease; and (4) the concluding remark is “While carrying out studies concerning CABG for CTOs will be difficult, a research agenda in this space is clearly needed.”
The article omits the following facts: (1) CTOs represent a technical challenge only for interventional cardiologists; (2) surgeons ignore CTOs, simply bypassing them if viability and coronary size >1mm are confirmed; (3) since the advent of CABG, CTO has never been an exclusion criterion, with millions of CTOs bypassed; (4) surgeons only treat patients referred by cardiologists; and (5) the Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery (SYNTAX) trial confirms the disproportionate inferiority of percutaneous coronary intervention (PCI) versus CABG for large cohorts of CTOs.
The correction has been made to the current online version of the article, which is available at http://circ.ahajournals.org/content/133/18/1826.full.
- © 2016 American Heart Association, Inc.