[Coronary heart disease and bypass surgery: a clinical cardiologist's view (author's transl)].

The main goal of bypass surgery (BPS) is improvement of angina pectoris (AP), of performance of LV function, and of the prognosis of AP. Recently reported statistics indicate a significant improvement of the prognosis after BPS, especially in double or triple vessel disease. The main indication remains severe AP with significantly impaired performance, but prognostic aspects can also affect the decision of BPS. The area of regional ischemia should be determined by means of angiography during stress, and regional flow should be measured (scintigraphy etc.) to allow a more accurate definition of critical narrowings.