Surgical management of unstable angina

Unstable angina pectoris encompasses a broad spectrum of clinical subsets with varying prognoses. It is impossible to identify which patients have severe obstructive coronary disease and, therefore, coronary arteriography should be employed. In patients with severe obstructive disease, coronary bypass surgery has resulted in dramatic symptomatic improvement and has improved the survival of patients with 2-and 3-vessel disease, as compared to medically treated groups. Aggressive preoperative medical management coupled with improved anesthetic and surgical techniques have aided in the salvage of these unstable patients.