Twenty Years of Coronary Bypass Surgery

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Abstract
Two decades ago Favaloro first reported successful aortocoronary bypass surgery using autologous saphenous-vein grafts in patients with symptomatic ischemic heart disease.1 It was quickly demonstrated that in properly selected cases, coronary bypass grafting increased myocardial blood flow and eliminated or alleviated symptoms in a high proportion of cases. Most impressive was the objective documentation of improvement in exercise tolerance and exercise-induced ischemia, something not previously observed with medical therapy.The new procedure was received enthusiastically, and often uncritically, in this country. The number of operations increased rapidly; about 230,000 were undertaken in 1987 in nonfederal hospitals alone (Robertson TL, Cardiac . . .