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April 3, 1972

Coronary Artery Bypass Procedures

JAMA. 1972;220(1):133. doi:10.1001/jama.1972.03200010113035

To the Editor.—  The editorial excerpt from Dr. Corday's address (219:507, 1972) casts a hard, cool factual light on the promising coronary artery bypass procedures. He has joined a growing band of skeptics (all, unfortunately, nonsurgeons) who are attempting to stem the stampede and one can endorse virtually his every point. Dr. Corday is one of the world's most distinguished cardiologists and his plea for a "national registry" cannot be ignored. Yet, I am astonished that nowhere in this thoughtful piece is there a hint of the desirability of controlled clinical trials. These are the most efficient method of getting honest (ie, minimally biased) results among truly comparable patients. A registry has merits insofar as bypass surgery will be pushed willy nilly by its enthusiasts (who formerly pushed Vineberg implants and other panaceas).1 However, a registry will serve mainly to codify "trial and error," which is the traditional