What resources should be made available for coronary artery bypass surgery in Europe

In the immediate future it seems correct to aim to provide for between 500 and 700 per million interventions for coronary artery disease per year. There is a continuing need for valve surgery, congenital heart surgery and miscellaneous conditions at a rate of about 150-200 per million per year. It is recommended that centres should be organised with a minimum of 750-1000 open heart procedures resulting in a minimum population requirement of between 1.2 M-1.5 M to support an individual unit. The likely revenue costs of running such a service at 1986 values is approximately 5-7 million pounds and such a unit is likely to have capital equipment of nearly 3 M pounds with an expected life span of seven to ten years. There is a continuing requirement to review the total need for surgery as more information becomes available and new techniques develop.