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Multiple coronary bypass grafting: current mortality and morbidity
Insights
Coronary artery bypass grafting is safe and effective for patients with severe coronary artery disease, including those with stable angina. This study found a low operative mortality and morbidity, supporting its use in select patient groups.
Area of Science:
- Cardiology
- Cardiac Surgery
Background:
- Coronary artery bypass surgery (CABS) is increasingly common but its efficacy is debated in certain patient populations.
- Critical reports question the benefits of CABS for specific patient groups.
Purpose of the Study:
- To review the safety and efficacy of multiple coronary bypass grafting for triple vessel disease.
- To evaluate the outcomes of CABS in patients with high-grade double and triple vessel disease and stable angina.
Main Methods:
- Retrospective review of 276 patients undergoing multiple coronary bypass grafting between March 1976 and October 1978.
- Inclusion of combined procedures such as valve replacement and ventricular aneurysmectomy.
- Analysis of operative mortality, perioperative infarction, and other nonfatal complications.
Main Results:
- Low operative mortality of 0.7% (2 deaths within 30 days) in 276 patients.
- Perioperative infarction occurred in 4% of patients (11 patients).
- Other nonfatal operative complications were reviewed and found to be manageable.
Conclusions:
- Coronary artery bypass surgery demonstrates overall safety and low morbidity in this patient cohort.
- The findings support the recommendation of CABS for controversial subsets, including patients with high-grade double and triple vessel disease and stable angina.
Abstract:
Although coronary artery bypass surgery has become increasingly popular in recent years, recent critical reports have cast doubt on its efficacy in certain groups of patients. Our report reviews a recent experience with multiple coronary bypass grafting for triple vessel disease. From March 1976 to October 1978, 276 patients received from three to nine coronary bypass grafts. Combined procedures including valve replacement and ventricular aneurysmectomy are included. There were two operative deaths (30 days) for a 0.7% operative mortality. Eleven patients (4%) sustained a perioperative infarction. Other nonfatal operative complications are reviewed. The overall safety and low morbidity allow us to recommend coronary bypass surgery to certain controversial subsets of patients, ie, those with high-grade double and triple vessel disease with stable angina.