Evolving status of operative versus nonoperative management of coronary arterial obstruction

The past 15 years has witnessed great change in the treatment of ischemic heart disease. The next decade should continue to show equally promising new approaches to diagnosis, management, and interventional therapy. The relative roles of surgery and angioplasty should become better defined. Clinical advances in the medical and surgical intervention for acute myocardial infarction will receive continued emphasis. The results of using the internal mammary artery as a preferred conduit for multiple bypasses should be available and data to prove or disprove percutaneous angioplasty as an enduring procedure will be known. It should be a stimulating period for all involved in the diagnosis and treatment of patients with coronary artery disease.