Limitations and Prospects of Coronary Artery Surgery

Abstract

Coronary atherosclerosis is discussed from the standpoint of natural history and survival. The operative treatment for ischemic heart disease is reviewed beginning with the advent of the venous autograft to the most recent advance, the internal mammary artery graft. Comparative survival between medical and surgical modes of treatment are described as well as factors in the revascularization selection process that directly influence longevity. During the last 6 years, experience in selection and a steady improvement in technical proficiency have brought about a decline in operative mortality and morbidity, thus yielding further improvement in postoperative long-term survival.