When we considered coronary artery bypass in 19731 we concluded that it was an effective means of relieving angina pectoris and worth considering where medical therapy had failed. Since then the influence of bypass on other aspects of ischaemic heart disease such as premature death, cardiac failure and myocardial infarction have been assessed and the risks of surgery reduced. This note reviews the present position: which patients are likely to benefit, and how patients should be selected and investigated.
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