Age alone does not decide between CTO PCI and bypass surgery. What matters is anatomy, symptoms, frailty, lung and kidney function, and patient preference.
When CTO PCI may be attractive
- Desire to avoid sternotomy and prolonged recovery
- Suitable CTO anatomy for experienced operators
- Significant symptoms despite medication
- Higher surgical risk due to other medical conditions
When bypass may still be preferred
- Extensive multi-vessel disease better treated surgically
- Concurrent need for other cardiac surgery
- Anatomy unfavourable for PCI after specialist review
The heart-team mindset
The best centres do not sell one procedure. They match the treatment to the person. For many older Melburnians, successful CTO PCI offers symptom relief with a shorter hospital stay — but it is not automatically “better” than bypass for everyone.
A second opinion can help you weigh both paths with clear eyes.