[Indications for surgery of the coronaries and its results (author's transl)].
In chronic angina pectoris surgery is indicated for all patients with bridgeable central stenoses, suitable distal vessels and patent peripheral coronary circulation, if function of the ventricle is not critically reduced. when more than one vessel is diseased and with isolated stenoses of the anterior interventricular branch of the left coronary a., it does hardly latter whether the angina pectoris can be treated conservatively or not. An absolute indication for revasculariation exists when stenoses of the main branches of the left coronary artery can be shown. Pre-infarct angina (unstable or crescendo-angina, threatened infarction) should, in younger patients, always lead to immediate diagnostic ascertainment. Where severe anatomic coronary changes are present, immediate surgery is indicated, although the real danger of infarction in such patients cannot be reliably predicated as yet. Post-infarct ventricular aneurysmus should be operated on when leftsided insufficiency increases or arrythmias cannot be controlled satisfactorily any more. Surgery can be undertaken with an acceptable risk, if patients are carefully selected. As far as we know from published statistics, the quality of life of such patients can be improved for some time. But their expectation of life after surgery cannot as yet be reliably predicted, because prospective observations of comparable groups of patients treated conservatively or surgically do not yet exist. From a prospective study of McNeer (22) it appears that in 2 randomized groups there was no significant difference in time of survival after 2 years. Neither the size of the material nor the period of follow-up are sufficient for definite evaluation.
D000208:Acute Disease; D000787:Angina Pectoris / Q000000981:diagnostic imaging*; D000790:Angiocardiography; D002908:Chronic Disease; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D006322:Heart Aneurysm / Q000601:surgery*; D006801:Humans; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000601:surgery
Indikationen zu koronarchirurgischen Eingriffen und deren Ergebnisse