[Coronary surgery in unstable angina pectoris]

Urgent surgical revascularisation for unstable angina is relatively frequent, though only where stabilization of angina with vigorous medical treatment is not successful. On the other hand, it has been shown that a large proportion of patients in whom unstable angina has been successfully stabilized subsequently suffer from severe chronic angina. Therefore it is recommended that coronarography be performed in all younger patients within a few days. If left main stem or three vessel disease is documented, aortocoronary bypass should be done during the same hospitalisation or, in suitable cases, percutaneous transluminal coronary angioplasty (PTCA) should be considered. Although some authors report an elevated risk for urgent revascularisation our own results do not confirm this. Operative mortality is not elevated and the functional results, including patency rate of grafts, do not differ from those in patients with chronic coronary heart disease.