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The Annals of Thoracic Surgery, Vol 19, 521-528, Copyright © 1975 by The Society of Thoracic Surgeons


ARTICLES

Unstable coronary artery disease: comparison of medical and surgical treatment

HW Bender Jr, RD Fisher, SL Faulkner and GC Friesinger

In eighty-eight patients with arteriographic findings of obstructive coronary artery disease and the clinical picture of unstable angina pectoris, a decision on operative or nonoperative management was made by the attending physician. Fifty-three of them subsequently underwent aortocoronary saphenous vein bypass grafting and 35 were continued on a program of medical therapy. A marked difference in the course after the first 30 days was noted, with most of the surgically managed patients being either asymptomatic or greatly improved following coronary artery bypass. Two-thirds of the medically treated patients had persistent severe angina pectoris and non was asymptomatic in a follow-up period averaging 20 months. There were 2 late deaths in the medical group and none in the surgical group. These findings indicate that coronary artery bypass operations can be performed with low risk during the unstable phase of coronary artery disease and that relief of angina can be anticipated. In contrast, nonoperative management of unstable coronary artery disease carries an appreciable risk of death or myocardial infarction, and the majority of patients treated nonoperatively continue to experience angina.


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K. V. Arom and F. L. Grover
Adult cardiac surgery during the first 50 years of the Southern Thoracic Surgical Association
Ann. Thorac. Surg., November 1, 2003; 76(90050): S17 - 46.
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Copyright © 1975 by The Society of Thoracic Surgeons.