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Bypass grafting versus medical treatment in angina

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Surgery leads to better symptomatic improvement and increased exercise tolerance compared to medical therapy. It is the treatment of choice for patients with left main stem stenosis or three-vessel disease with or without impaired left ventricular function.

Various studies have given valuable information with respect to survival rates comparing surgery and medical therapy:

  • the Veterans Administration Study showed a similar survival rate at 11 years for patients with chronic stable angina treated with either medical therapy or surgery

  • the European Coronary Surgical Study showed surgery improved survival in patients with 3-vessel disease and patients with 2-vessel disease if there was a lesion in the proximal left anterior descending artery. There were no significant differences in survival in single vessel disease or 2-vessel disease without an LAD lesion

  • Coronary Artery Surgery Study - involved patients with mild angina or previous myocardial infarction. Surgery increased survival in patients with impaired left ventricular function

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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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