Coronary-Artery Surgery at the Crossroads

The surgical treatment of coronary-artery disease began early in this century when surgical sympathectomy was reported as a successful treatment for angina pectoris. Since then a variety of procedures have been tried, all of which were greeted with initial enthusiasm, which then rapidly waned. However, aortocoronary-artery bypass graft (CABG) is qualitatively superior to the earlier operations because it is associated with marked and sustained relief of angina pectoris in most patients. Since the delivery of substantial quantities of blood to previously ischemic myocardium can be accomplished with relatively low mortality by a skilled, experienced surgical team, the indications for this . . .