Aortocoronary vein bypass is the most recent and promising of the surgical procedures for revascularizing the heart. At present there is a wide range of opinion regarding indications for this operation and the environment in which it should be carried out. Many physicians now feel under pressure to recommend the procedure for increasing numbers of patients and this in turn has resulted in pressure on hospitals for new and expanded cardiac surgical programs. Therefore, the time is right for an authoritative statement on the current status of this operation with guidelines for establishing quality surgical programs for these patients. The recent statement of the Inter-Society Commission for Heart Disease Resources (ICHD)1 does much to fill this need.
The ICHD was created three years ago under a grant from the Regional Medical Programs Service to develop guidelines for optimal medical resources for the prevention and care of patients with cardiovascular