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Aorto-coronary artery saphenous vein bypass surgery. A ten-year follow-up
Insights
This 10-year follow-up study of coronary bypass surgery found a 68% survival rate. Factors like age and preoperative heart function significantly impacted patient survival and angina recurrence.
Area of Science:
- Cardiovascular Surgery
- Cardiac Surgery Outcomes
- Long-term Follow-up Studies
Background:
- Coronary artery bypass grafting (CABG) is a critical intervention for ischemic heart disease.
- Understanding long-term outcomes is essential for patient management and surgical technique refinement.
Purpose of the Study:
- To report the 10-year follow-up results of patients who underwent coronary bypass surgery.
- To identify factors influencing survival and clinical outcomes after CABG.
Main Methods:
- A consecutive series of 126 patients undergoing CABG between 1970-1972 were analyzed.
- Data included patient demographics, preoperative conditions, surgical details, graft patency, and long-term survival.
- Statistical analysis identified factors associated with survival and clinical response.
Main Results:
- The overall 10-year survival rate was 68.0%.
- Age, preoperative ST-segment depression, myocardial infarction history, and ventricular function were significant predictors of survival.
- Graft patency was 78.4% early post-operatively. 64.9% of survivors experienced angina recurrence.
Conclusions:
- Coronary bypass surgery demonstrated a substantial 10-year survival rate.
- Preoperative patient characteristics significantly influence long-term outcomes.
- Completeness of revascularization correlated positively with improved clinical response.
Abstract:
The 10-year follow-up of consecutive series of 126 patients who underwent coronary bypass surgery from January 1970 through December 1972 without associated procedures is reported. There were 112 men and 14 women with a mean age of 50.3 +/- 8.0 years. Indications for operation were stable angina pectoris in 35 cases and unstable angina in 91 cases. Eleven patients had one-vessel disease, 55 patients had two-vessel disease and 60 patients had three-vessel disease. The mean number of grafts per patient was 1.8. Graft patency rate was 78.4% at the time of early angiographic control (from one to 24 months). There were two early deaths and 47 late deaths. One patient was last to follow-up. Twenty-six of the late deaths were cardiac in nature (57.7%). The overall 10-year survival rate was 68.0 +/- 4.1%. The factors most clearly related to survival rate were: age (p less than 0.05) ischaemic ST-segment depressions on resting preoperative electrocardiogram (p less than 0.005), preoperative electrocardiographic evidence of anterior, septal or lateral myocardial infarction (p less than 0.05), ventricular function as assessed by preoperative left ventriculography (p less than 0.05). During the follow-up period 35.1% of survivors had had no recurrence of angina and 64.9% had experienced at least one episode of angina. At the ten-year evaluation 33 surviving patients considered themselves free of angina, 27 patients considered the angina to be less severe than before the operation and four considered it to be the same or more severe. A significant positive correlation was noted between clinical response and completeness of revascularization (p less than 0.05).