Surgery for ischemic heart disease

Surgical treatment for ischemic heart disease continues to evolve. The long-term benefit of coronary artery bypass grafting can be shown to extend for 15 to 20 years. The long-term patency achieved with internal thoracic artery grafts has extended the already good results of coronary artery bypass grafting. It is the surgeon's hope that the pursuit of multiple arterial grafting will further extend these results. Operations continue to increase in complexity and include a growing number of reoperations. Techniques to deal with these situations have continued to evolve so that the operative mortality remains low. The role of angioplasty in patients with multiple-vessel coronary artery disease has not been firmly established. However, increasing data indicate that in patients with triple-vessel disease and depressed ventricular function, complete surgical revascularization is the treatment of choice.