[Unstable angina pectoris from surgical view (author's transl)]

Between January 1974 and September 1977 37 patients with unstable angina pectoris have been treated (7,6% of the patients operated upon). 49% suffered from an old myocardial infarct, 86% had a 2 or more coronary vessel disease, and only 4 patients showed critical stenoses on the left main stem. We preferred a combined medical and surgical treatment. By means of medical treatment all patients but one became painfree. At the same time coronary angiography had been performed without any complications. 37 patients received 67 vein bypasses (graft-patient-relation of 1,8). The surgical degree of revascularization was 80%. The hospital mortality came to 2,7%, the late mortality to 2,8%. Perioperatively 3 patients underwent a myocardial infarction. 84% of the patients were painfree and clinically improved. 41% went back to work in their old jobs. 84% of the vein bypasses were open. The effective degree of revascularization was 67%.

There is no difference between patients with stable and unstable angina referring to coronary morphology, rate of survival and of surgical complications as well as to clinical and objective improvement. We recommend an early but not emergency angiography and we prefer an elective surgical treatment and not an emergency procedure.