The Practice of Coronary Artery Bypass Surgery (Topics in Cardiovascular Disease)

Few advances in cardiovascular medicine have so captured the inter­ est of physicians and the public alike as has coronary artery bypass surgery. Cardiologists who lived through the era of false hopes and frustrations of previous" operations" for coronary artery disease can fully appreciate what this major advance offers to their patients. The number of papers on this topic presented at national meetings attest to its popularity, but also make it increasingly difficult for anyone to assimilate all the data. Practitioners who must consider coronary artery bypass surgery for their patients may thus have difficulty in coming to some rational decision regarding the indications for the operation and its consequences. Depending on the "authority" that one reads, there is still some controversy as to which patients are candidates for coronary artery surgery. This monograph on the prac­ tice of coronary artery bypass surgery, therefore, comes as a welcome boon to cardiologists, surgeons, internists, and general practitioners who must consider referring their patients for such surgery. It presents a balanced and reasonable picture of the overall subject, in addition to containing important information on such topics as opera­ tive technique and economic impact. Dr. Miller has done an outstand­ ing job in bringing together in one text the important considerations related to the evaluation of patients, the natural history of coronary artery disease and the benefits and problems associated with bypass surgery. Front Matter....Pages i-xvi A Short History of Myocardial Revascularization....Pages 1-14 The Clinical Course of Patients with Coronary Artery Disease....Pages 15-31 The Benefits of Coronary Artery Bypass Surgery....Pages 33-58 The Risks of Coronary Artery Bypass Surgery....Pages 59-92 The Preoperative Evaluation....Pages 93-117 Practice Patterns and Factors Influencing Selection of Patients for Bypass Surgery....Pages 119-135 The Use of Extracorporeal Circulation in Bypass Surgery....Pages 137-152 Diagnostic Assessment of Myocardial Injury after Bypass Surgery....Pages 153-175 Myocardial Protection during Bypass Surgery....Pages 177-188 The Role of the Internal Mammary Artery and Other Conduits in Coronary Artery Surgery....Pages 189-204 Saphenous Vein Aortocoronary Bypass Grafts: Surgical Techniques....Pages 205-217 The Economics of Bypass Surgery....Pages 219-231 Back Matter....Pages 233-237