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Direct myocardial revascularisation: experience with 9364 operations
Insights
Aortocoronary bypass (ACB) surgery significantly improves outcomes for coronary insufficiency patients. This surgical treatment offers better symptom relief and increased life expectancy compared to medical management.
Area of Science:
- Cardiology
- Cardiac Surgery
- Vascular Surgery
Background:
- Coronary insufficiency poses significant health risks.
- Medical management has limitations in improving life expectancy and symptoms.
Purpose of the Study:
- To evaluate the effectiveness of direct myocardial revascularization using aortocoronary bypass (ACB) surgery.
- To compare surgical outcomes with medical treatment for coronary insufficiency.
Main Methods:
- Analysis of 9364 consecutive patients undergoing ACB between 1968 and 1976.
- Comparison of early mortality, late survival, and symptom improvement rates.
Main Results:
- Hospital mortality for ACB alone was 3.9%, decreasing to 2.2% in 1976.
- 88% of surviving patients experienced symptom improvement or were symptom-free.
- Eight-year survival rate was 80% for ACB patients.
Conclusions:
- Aortocoronary bypass (ACB) surgery demonstrates superiority over medical treatment for coronary insufficiency.
- Surgical intervention leads to enhanced symptomatic relief and increased life expectancy.
- ACB is a highly effective treatment for improving patient outcomes in coronary insufficiency.
Abstract:
Between July 1968 and December 1976, 9364 consecutive patients with coronary insufficiency underwent direct myocardial revascularisation using aortocoronary bypass (ACB). Among these patients 8017 had ACB alone, and the remaining 1347 had ACB in addition to correction of other cardiac and vascular lesions. In the series of patients having ACB alone the hospital (early) mortality was 3.9%, but for 2383 surgical patients in 1976 this figure was 2.2%. Operative mortality was higher for women (6.85%) than for men (3.5%), but late survival was about the same for both sexes. Among surviving patients 88% were improved or symptom-free after undergoing ACB. According to our data, at the end of eight years 80% of the patients will be survivors. These results, when compared with other series of patients treated medically, indicate the superiority of surgical treatment both in terms of symptomatic relief and also in increased life expectancy.