Are There Indications for Surgery in Asymptomatic Patients?

  • A. Selzer
Conference paper


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.



Depression Ischemia Luminal Cardiol Bursitis 


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Copyright information

© Springer Verlag Berlin Heidelberg 1979

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  • A. Selzer

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