Can Med Assoc J. 1977 Sep 3;117(5):451-9.
Coronary artery disease has been described as the largest public health problem in Western society. In spite of the many advances in recent years in its medical management, many patients remain disabled even after optimal medical therapy. The aortocoronary bypass operation, introduced in the mid-1960s, has been shown to have consistent subjective and objective effects on the course of the disease in a large proportion of patients. The procedure consists of inserting a portion of the saphenous vein into both the aorta and a coronary artery to bypass the obstruction. It is usual now to bypass obstructions in several coronary arteries at the same operation if necessary. The prognosis for patients with ischemic heart disease with medical management depends on the extent of the disease. Patients with obstruction of only one coronary artery have a prognosis very little different from normal. On the other hand, obstruction of several arteries is consistently associated with a mortality approaching or exceeding 10% per year.
冠状动脉疾病被认为是西方社会最大的公共卫生问题。尽管近年来在其药物治疗方面取得了许多进展，但许多患者即使经过最佳药物治疗后仍有残疾。20世纪60年代中期引入的主动脉冠状动脉搭桥手术已被证明在很大一部分患者中对疾病进程有一致的主观和客观影响。该手术包括将一段大隐静脉插入主动脉和冠状动脉以绕过阻塞部位。现在，如果有必要，通常会在同一次手术中绕过多条冠状动脉的阻塞部位。缺血性心脏病患者药物治疗的预后取决于疾病的程度。仅一条冠状动脉阻塞的患者预后与正常人相差不大。另一方面，多条动脉阻塞一直与每年接近或超过10%的死亡率相关。
