[The effect of coronary surgery on the prognosis of angina pectoris].

The literature on the influence of aortocoronary bypass surgery is reviewed with respect to life expectancy and symptoms. Preliminary results of the European prospective randomized coronary study are also presented. There was no significant difference in clinical or angiographic criteria as between the medically and surgically treated patient groups. For the total cohorts, survival did not significantly differ, though in patients with 3-vessel disease, mortality was significantly higher in the medically treated group. This observation requires confirmation before it is allowed to influence our decisions. In the same prospective trial, surgery improved symptoms in 4/5 of the patients and eliminated angina in half. With medical treatment, fewer than half of the patients experienced further improvement during the same time period and only 15% became symptom-free.