title: [Coronary heart disease. Surgical development in the last 10 years--status of possibilities in West Germany].
abstract: This article addresses both the operative facilities for coronary bypass surgery in the Federal Republic of Germany and the surgical progress made in this field during the past 10 years. Like in many other countries, there is a continuing critical discrepancy between the number of patients offered for treatment and those operated upon. The reasons for this lack of facilities is explained. Recent moves by the respective Ministries and the public insurance system, however, have raised the expectation that this problem will be eliminated by the end of the decade. Progress in coronary surgery which is well mirrored by our own experience has undergone substantial changes in regards to patients selection and surgical approaches used. There has been a sharp increase in emergency coronary surgery. The proportion of combined procedures on the coronary arteries and myocardium or peripheral vessels has risen to approximately 10 while the rate of reoperation has not yet exceeded 5%. Resection of left ventricular aneurysms has largely been limited to patients with additional coronary stenoses and/or ventricular tachycardia. Complete revascularization (3.2 peripheral coronary anastomoses per patient) has become the rule and circular sequential vein bypass the preferred method for achieving this aim. On the basis of our experience it may be prognosticated that mammary artery bypass and open endarterectomy also of the left coronary system will play an increasing role in the near future.
mesh_terms: D000800:Angioplasty, Balloon / Q000639:trends; D001026:Coronary Artery Bypass / Q000639:trends*; D003327:Coronary Disease / Q000601:surgery*; D004691:Endarterectomy / Q000639:trends; D005544:Forecasting; D005860:Germany, West; D006322:Heart Aneurysm / Q000601:surgery; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000639:trends; D011379:Prognosis
vernacular_title: Koronare Herzkrankheit. Chirurgische Entwicklung über die letzten 10 Jahre--Stand der Möglichkeiten in der Bundesrepublik Deutschland.