[Surgical treatment of angina pectoris].

Coronary artery bypass grafting is a very effective therapy for the relief of angina pectoris. It has been demonstrated that, in certain subsets of patients, it prolongs life when compared to other treatment options. However, the introduction and development of less invasive percutaneous procedures has changed the profile of patients subject to coronary surgery. They are older, with more extensive coronary disease and comorbid conditions. The challenge of coronary artery bypass grafting is to maintain the excellent results obtained tha far and to compete with percutaneous revascularization procedures regarding morbidity and cost-effectiveness. We review the most important randomized trials of coronary surgery, especially those which consider its role in multivessel disease versus angioplasty and the new trends that try to make it cheaper and less invasive.