The second clinical study under grant R01HL44719, began in December, 1995 and was a prospective trial of 412 patients who were evaluated pre-operatively, monitored intra-operatively and followed post-operatively according to a standardized surveillance protocol. Patients were randomized to two forms of hemodynamic management during cardiopulmonary bypass. In one group, the intra-operative mean arterial pressure (MAP) during bypass was maintained at 65 mm Hg (or 81 mm Hg at full flow), thus employing the most effective strategy from the investigators' first trial. In the second group, the intra-operative MAP was maintained at their pre-operative MAP (but below 90 mm Hg), a strategy supported by data from the first trial. The principal outcome was the occurrence of any one of the following: mortality at six months, major cardiopulmonary morbidity (i.e., myocardial infarction, pulmonary edema, cardiogenic shock or low flow state), cognitive complications (defined by a summary definition which included improvement and decline on neuropsychologic tests of memory, psychomotor/attention, and linguistic function), major neurologic complications (i.e., new focal deficits, such as hemiplegia, aphasia, cortical blindness) and significant deterioration in functional status at six months postoperatively. The long term objective was to preserve and further improve the quality of life after CABG.