A review of aortocoronary bypass grafting found insufficient controlled data to prove that surgery provides persistent symptomatic relief, prevents myocardial infarction, or prolongs life.
Despite a decade of experience with aortocoronary bypass grafting embracing 300,000 or more operations, indications for its use remain controversial. The controversy persists because of a lack of adequate controls with which to compare the clinical course of operated patients; only 1248 have been reported who have been studied in a carefully controlled and random manner. Benefit has been claimed frequently by comparing the course of patients treated surgically with medically treated patients followed the decade before. Such comparisons are not valid in view of the well documented changes in the natural history of coronary artery disease that have been occurring during the last decade. Despite a low operative mortality and rate of graft closure, available data in the literature do not indicate that initial symptomatic improvement necessarily persists, or that myocardial infarctions, arrhythmias, or congestive heart failure will be prevented, or that life will be prolonged in the vast majority of operated patients.
McIntosh et al. (Wed,) conducted a review in Coronary artery disease. Aortocoronary bypass grafting vs. Medical treatment was evaluated on Symptomatic improvement, myocardial infarction, arrhythmias, congestive heart failure, or prolonged life. A review of aortocoronary bypass grafting found insufficient controlled data to prove that surgery provides persistent symptomatic relief, prevents myocardial infarction, or prolongs life.