Aortocoronary bypass grafting (541 grafts) was employed in the management of 242 patients with obstructive coronary artery disease during a 25-month period. The operative mortality was 8.7%. Operative indications were chronic angina (181), congestive failure (26), preinfarction angina (10), ventricular aneurysm (5), acute myocardial infarction (3), valvular disease (12), tachyarrhythmia (4), and prophylactic (1). Angina pectoris was minimal or absent, postoperatively, in 93% of the patients operated on principally for this. The mortality in this group was 3.9% and varied according to ventricular function. The operative mortality of patients with congestive heart failure was 19%, and 70% were significantly improved.