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Are There Indications for Surgery in Asymptomatic Patients?

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Abstract

In every form of treatment, be it medical or surgical, it is neces­sary to evaluate the risk-benefit relationship. The performance of aortocoronary bypass operation in patients who are free from symp­toms, apparently in good health, requires a particularly careful analysis of factors involved because the operation is primarily of prophylactic nature, that is, aimed at prevention of future problems. Justification for the performance of a major heart operation in an apparently well subject rests upon four assumptions:

  1. 1.

    Stenotic lesions in coronary arteries are inevitably and rapidly progressive.

  2. 2.

    As a corollary of the previous statement, patients with signifi­cant stenotic lesions are always at the high risk of acute myo­cardial infarction or sudden death.

  3. 3.

    Bypass operations successfully and reliably protect the patient from these disastrous events.

  4. 4.

    Clinical symptoms are unreliable as guidelines to myocardial ischemia.

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References

  1. Vlodaver, Z., Edwards, J.E.: Pathology of coronary atherosclerosis. Prog. Cardiovasc. Dis. 14, 256 (1971)

    Article  PubMed  CAS  Google Scholar 

  2. McGregor, M.: The coronary collateral circulation: A significant compensatory mechanism or a functionless quirk of nature. Circulation 52, 529 (1975)

    PubMed  CAS  Google Scholar 

  3. Pasternak, R., Cohn, K., Selzer, A., Langston, M.F. (Jr.): Enhanced rate of progression of coronary artery disease following aortocoronary saphenous vein bypass surgery. Am. J. Med. 58, 166 (1975)

    Article  PubMed  CAS  Google Scholar 

  4. Murphy, M.L. Hultgren, H.N., Detre, K., Thomsen, J., Takaro, T., et al: Treatment of chronic stable angina. N. Engl. J. Med. 297, 621 (1977)

    Article  PubMed  CAS  Google Scholar 

  5. Hutter, A.M., Russel, R.O. (Jr.), Resnekov, L., Wölk, M., Rosati, R.A., Conti, C.R., Becker, L., Biddle, T., Schroeder, J.S., Kaplan, E.M., Gilbert, J.P., Mock, M.B.: Unstable angina pectoris. National randomized study of surgical vs. medical therapy: Results in 1, 2 and 3 vessel disease. Circulation55–56 [Suppl.III], 60 (1977) (Abs.)

    Google Scholar 

  6. Selzer, A., Cohn, K.: Asymptomatic coronary artery disease and coronary bypass surgery. Am. J. Cardiol. 39, 614 (1977)

    Article  PubMed  CAS  Google Scholar 

  7. Vlietsra, R.D.E., Assad-Morell, J.L., Frye, R., Elveback, L.R., Connoly, D.C., Ritman, E.I;, Pluth, J.R., Barnhorst, D.A., Danielson, G.K., Wallace, R.B.: Survival predictors in coronary artery disease. Medical and surgical comparisons. Mayo Clin. Proc. 52, 85 (1977)

    Google Scholar 

  8. Gross, H., Vaid, A.K., Cohen, M.V.: Prognosis in patients rejected for coronary revascularization surgery. Am. J. Med. 64, 9 (1978)

    Article  PubMed  CAS  Google Scholar 

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© 1979 Springer Verlag Berlin Heidelberg

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Selzer, A. (1979). Are There Indications for Surgery in Asymptomatic Patients?. In: Roskamm, H., Schmuziger, M. (eds) Coronary Heart Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-67295-8_6

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  • DOI: https://doi.org/10.1007/978-3-642-67295-8_6

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-67297-2

  • Online ISBN: 978-3-642-67295-8

  • eBook Packages: Springer Book Archive

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