Coronary Artery Surgery —Is It Time?

There is at present in the United States a great vogue in coronary bypass vein surgery for the relief of intractable angina and presumptively to lessen the chances of cardiac infarction and death. Recent’ studies on the natural history of coronary artery disease using angiographic techniques indicate that in many cases, despite anginal pain and even electrocardiographic evidence of ischæmia or past infarction, the prognosis can be good at five to seven years. Bad past experience in this field has been ignored to the extent that it is now considered virtually impossible to set up a prospective randomly controlled trial. It is suggested that this type of surgery be restricted to a few centres that are prepared to keep a strict registry of all data so that we may eventually learn the indications or contraindications for this procedure.