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Some reflections on the coronary bypass operation.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Glenn, William W. L. |
| Copyright Year | 1972 |
| Abstract | SUMMARY A promising new operation-coronary bypass-has been developed for the treatment of coronary heart disease. However, because of the nature of the underlying disease and the minute size of the vessels to be anastomosed, its long-range prospects are in doubt. At this point in time there is no evidence that the operation either prevents infarction or prolongs life, and great caution is urged in applying it, reserving it for those who have life-threatening coronary artery disease, are clearly recalci-trant to optimum medical management, and have apparently nonnal coronary vessels distal to the point of stenosis. There is an urgent need for a better definition of the indications for operation in patients with coronary artery disease based on a study of the natural history of this coindition. Prophylactic operation for patients with a compromised coronary circulation with or without angina must await long-term results of therapeutic operation. I N VIEW OF THE extraordinary interest in the current surgical operation for coronary atheroselerosis, and the great expansion of our medical facilities and training programs to xvhich we would be committed by enthusiastic endorsement of this operation, I believe the time is propitious for an airing of the situation. I feel obligated to present to you evidence that suggests a cautious approach to this operation, while at the same time I acknowledge its successful application to certain patients with life-threatening myocardial ischemia. It is of course not possible to determine precisely the number of patients with coro-nlary heart disease in the United States at this moment, but let us look at some figures. Though grossly approximate at best, they do reveal the magnitude of the case load. In 1967 heart and blood vessel diseases accounted for 54.1% of the deaths in the United States, or just over a million deaths.' Coronary heart disease (CHD) accounted for 57.2% of these, or 573,153 deaths (Code 420 Initernational Classification of Disease, 7th revision), the highest rate in the world probably, except for Finland's.2 According to figures from 1962 (the common reference point in Keys' study), in the 40-59 age group, where at least two thirds of CHD is found, 33.9-42.3%; of deaths in white males were due to the disease (fig. 1).-2 Of the United States sample of 2571 railroad men aged 40-59 years, 25 in the sample, or 1% (a surprisingly smaller percentage than in samples from some of the other countries in this study), … |
| Starting Page | 3858 |
| Ending Page | 3866 |
| Page Count | 9 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://circ.ahajournals.org/content/circulationaha/45/4/869.full.pdf |
| Alternate Webpage(s) | http://circ.ahajournals.org/content/circulationaha/45/4/869.full.pdf?download=true |
| PubMed reference number | 5016019v1 |
| Volume Number | 45 |
| Issue Number | 4 |
| Journal | Circulation |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Angina Pectoris Arteriopathic disease Blood Vessel Cessation of life Choline Dehydrogenase, Mitochondrial Coronary Artery Bypass Surgery Coronary Artery Disease Coronary Circulation Coronary Vessels Coronary heart disease Fifty Nine Heart Diseases Heart failure Hematological Disease Infarction Myocardial Ischemia Natural History Patients Small Surgical revision Training Programs |
| Content Type | Text |
| Resource Type | Article |
