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[Long-term follow-up of surgical patients with ischemic heart disease]
Insights
Long-term results show aortocoronary bypass grafting significantly improves survival and quality of life for angina pectoris patients. This surgery also prevents myocardial infarction in the long term.
Area of Science:
- Cardiovascular Surgery
- Cardiac Surgery Outcomes
- Long-term Patient Follow-up
Context:
- Analysis of 333 patients undergoing coronary artery operations between 1974-1982.
- Includes aortocoronary bypass grafting (269 patients), operations for myocardial infarction (44 patients), and combined procedures (20 patients).
Purpose:
- To report the long-term follow-up and outcomes of various coronary artery operations.
- To evaluate the effectiveness and long-term benefits of aortocoronary bypass grafting.
Summary:
- The 5-year survival rates were 92.9% for bypass grafting, 72.7% for myocardial infarction operations, and 80% for combined procedures.
- Aortocoronary bypass grafting led to asymptomatic or less symptomatic states in a significant majority of patients long-term.
- Postoperative studies indicated improved coronary blood flow, left ventricular function, and myocardial metabolism, enhancing quality of life.
Impact:
- Successful aortocoronary bypass grafting demonstrated a protective effect against subsequent myocardial infarction.
- Patients who survived coronary artery operations, particularly bypass grafting, experienced satisfactory long-term results and improved quality of life.
- The study highlights the enduring benefits of surgical intervention for coronary artery disease.
Abstract:
Long-term follow-up of a consecutive 333 patients who underwent coronary artery operations from 1974 through December of 1982 is reported. The surgical procedures in this series consisted of aortocoronary bypass grafting for angina pectoris in 269 patients (Group I), various operations for myocardial infarction and its mechanical complications in 44 patients (Group II), and combined operative procedures in 20 patients (Group III). The 5 year survival rate of Group I, Group II and Group III were 92.9% 72.7% and 80% respectively. Nine out of 14 late deaths in the whole group were not related cardiac deaths. Sixty eight patients with aorto coronary bypass grafting were asymptomatic and 27% were less symptomatic in the long term periods. The postoperative study indicates that aorto coronary bypass grafting increased coronary blood flow estimated by regional coronary venous flow associated with improvement of left ventricular function and myocardial metabolism resulting in so called "better quality of life". The successful aorto-coronary bypass grafting prevented the incidence of myocardial infarction at the time of subsequent combined vascular or malignant operation in the same individuals. Although the early death was somewhat high in the patients with acute myocardial infarction, the patients who survived the operation had the satisfactory long term results.