THE SURGICAL RISK IN PATIENTS WITH CORONARY DISEASE

The association of coronary disease and surgical conditions presents a problem of great magnitude to both the clinician and the surgeon. It is generally conceded that the patient with coronary disease faces operative procedures with hazards considerably greater than the comparable patient with a normal heart. In fact, the premise may be stated that even the individual with coronary disease who is not confronted with the necessity of surgical intervention constantly lives under the hazards of his disease, and the reality of these hazards becomes evident when one recalls to mind the frequent occurrence of sudden death of such patients.

There are, however, numerous instances when patients with coronary disease harbor coexisting diseases which demand surgical procedures and in which life cannot be extended without operation. Notable examples are malignant diseases in which clinical evidence supports the fact that there is a reasonable chance of cure by operation and certain