Coronary-Artery Bypass Surgery: It Works, but Why?

Editorials1 June 1978Coronary-Artery Bypass Surgery: It Works, but Why?BERNADINE H. BULKLEY, M.D., RICHARD S. Ross, M.D.BERNADINE H. BULKLEY, M.D.Search for more papers by this author, RICHARD S. Ross, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-88-6-835 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptCoronary-artery bypass surgery is overwhelmingly successful in the symptomatic treatment of angina pectoris. Eighty percent to 90% of patients who undergo this procedure experience relief of symptoms and 60% to 70% become pain-free (1). These are indeed dramatic and indisputable results: for most patients, incapacitating angina pectoris is cured by coronary-artery bypass surgery. It works, but why?The operation is designed to provide a new channel for blood flow around a point of obstruction in a diseased coronary artery; therefore, relief of angina is usually attributed to the new blood supply. Perhaps successful and complete revascularization of the ischemic myocardium...References1. NORMAN J: Coronary Artery Medicine and Surgery. New York, Appleton-Century-Crofts, 1976 Google Scholar2. BARTELBEHARPETERORGAINKONG AVREY: Exercise stress testing in evaluation of aortocoronary bypass surgery. Report of 123 patients. Circulation 48:141-148, 1973 CrossrefMedlineGoogle Scholar3. BERNDTMILLERSILVERMANSTINSONHARRISONSCHROEDER TDJEDJ: Coronary bypass surgery for unstable angina pectoris. Clinical follow-up studies of postoperative treadmill electrocardiograms. Am J Med 58:171-176, 1975 CrossrefMedlineGoogle Scholar4. MNAYERCHAHINERAIZNER MRA: Mechanisms of angina relief in patients after coronary artery bypass surgery. Br Heart J 39:605-609, 1977 CrossrefMedlineGoogle Scholar5. ROSS R: The problem of ischemic heart disease: current approach and implications for curriculum design. Johns Hopkins Med J 138:217-228, 1976 MedlineGoogle Scholar6. MURPHYHULTGRENDETRETHOMSENTAKARO MHKJT AND PARTICIPANTS OF THE VETERANS ADMINISTRATION COOPERATIVE STUDY: Treatment of chronic stable angina. A preliminary report of survival data of the randomized Veterans Administration Cooperative Study. N Engl J Med 297:621-627, 1977 CrossrefMedlineGoogle Scholar7. CUTLER E: The present status of the treatment of angina pectoris by cervical sympathectomy. Ann Clin Med 5:1004-1013, 1927 Google Scholar8. BECK C: The development of a new blood supply to the heart by operation. Ann Surg 102:801-813, 1935 CrossrefMedlineGoogle Scholar9. VINEBERGNILOFF AP: The value of surgical treatment of coronary artery occlusion by implantation of the internal mammary artery into the ventricular myocardium. Surg Gynecol Obstet 91:551-558, 1950 MedlineGoogle Scholar10. COBBTHOMASDILLARDMERENDINOBRUCE LGDKR: An evaluation of internal-mammary-artery ligation by a double-blind technic. New Engl J Med 260:1115-1118, 1959 CrossrefMedlineGoogle Scholar11. DIMONDKITTLECROCKETT ECJ: Comparison of internal mammary artery ligation and sham operation for angina pectoris. Am J Cardiol 5:483-486, 1960 CrossrefMedlineGoogle Scholar12. BEECHER H: Surgery as placebo. JAMA 176:1102-1107, 1961 CrossrefMedlineGoogle Scholar13. ACHUFFGRIFFITHCONTIHUMPHRIESBRAWLEYGOTTROSS SLCJRVR: The "angina producing" myocardial segment. An approach to the interpretation of results of coronary bypass surgery. Am J Cardiol 36:723-733, 1975 CrossrefMedlineGoogle Scholar14. BULKLEYHUTCHINS BG: Myocardial consequences of coronary artery bypass graft surgery. The paradox of necrosis in areas of revascularization. Circulation 56:906-913, 1977 CrossrefMedlineGoogle Scholar15. PHILLIPSPROUDFITLIMSHELDON DWJW: Perioperative myocardial infarction: angiographic correlations (abstract). Am J Cardiol 39:269, 1977 Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Department of Medicine The Johns Hopkins University School of Medicine Baltimore, Maryland PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byCoronary bypass graft fate and patient outcome: Angiographic follow-up of 5,065 grafts related to survival and reoperation in 1,388 patients during 25 yearsCORONARY BYPASS SURGERYKoronare HerzkrankheitProspective assessment of regional myocardial perfusion before and after coronary revascularization surgery by Quantitative Thallium-201 scintigraphyPathology of coronary artery bypass graft surgeryWorking status of patients following coronary bypass surgeryUnnecessary Surgery 1 June 1978Volume 88, Issue 6Page: 835-836KeywordsAnginaBloodBlood flowCoronary arteriesMyocardiumRevascularizationSurgery Issue Published: 1 June 1978 PDF downloadLoading ...