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November 14, 1977

Coronary Artery Surgery: A Critical Review

JAMA. 1977;238(20):2197. doi:10.1001/jama.1977.03280210089038

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.


Full of "dangerous ideas, i.e., those which raise doubts," this monograph challenges the widespread faith in coronary artery bypass grafting (CABG). By claiming to expose the "unscientific belief system and biased methodology" that nurtured its growth and by detailing weaknesses of publications "written with the certainty of a nuclear scientist and the methodology of an alchemist," the author rekindles scepticism about CABG.

With this rekindling of doubt and insistence on proper verification, however, comes a responsibility to avoid the editorial double standard: in this regard, the book seriously suffers from one-sidedness. For example, more often than not, articles against the proved value of CABG are quoted without criticism. Meanwhile, studies that report objective clinical and physiological improvement after CABG are relentlessly attacked or misquoted.

While such a bias against CABG may make some readers feel mistrustful of the book, even CABG enthusiasts will enjoy the sections covering the psychological and