Does coronary bypass surgery improve long-term survival?
William L. Proudfit, MDAddress reprint requests to W.L.R, Department of Cardiology, The Cleveland Clinic Foundation, One Clinic Center, 9500 Euclid Avenue, Cleveland, Ohio 44195.
The question posed by the title implies comparison of coronary bypass surgery with some alternative therapeutic approach. At present, there are three principal alternatives: no treatment, medical therapy, and percutaneous transluminal coronary angioplasty. Admitting that definitive data on long-term survival are lacking, the clinician is faced with a choice based on incomplete knowledge—a common dilemma in clinical practice. This discussion is restricted to symptomatic coronary artery disease.