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Sounding board. Are randomized trials appropriate for evaluating new operations?

L I Bonchek
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Coronary Artery BypassDrug EvaluationEvaluation Studies as TopicHeart Valve ProsthesisHumansProspective StudiesRandom AllocationResearch DesignSurgical Procedures, OperativeUnited StatesJournal Article

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L I Bonchek. 1979-07-05. Sounding board. Are randomized trials appropriate for evaluating new operations?. https://doi.org/10.1056/nejm197907053010110

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Subxiphoid approach for implantable cardioverter defibrillator in patients with previous coronary bypass surgery.

From February 1988 until August 1991, 28 patients with prior coronary artery bypass grafting (CABG) received implantable cardioverter defibrillator (ICD) therapy via a subxiphoid approach. Only one patient required conversion to a median sternotomy incision. The mean defibrillation threshold was 11.9 +/- 4.4 J. The mean R wave was 8.2 +/- 3.7 mV. One perioperative death occurred due to heart failure (mortality rate 1/28 [3.50%]). No patient required reexploration for bleeding. The subxiphoid method for ICD electrode implantation is safe and reliable in patients with prior CABG surgery.

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