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Clinical outcome in venous coronary artery bypass grafting: a 15-year follow-up study
B L van Brussel1, J M Ernst, N M Ernst
1Department of Cardiology, St Antonius Hospital, Nieuwegein, The Netherlands.
Objective:
We investigated the clinical outcome of venous coronary artery bypass graft surgery.
Methods:
A study group consisting of 428 consecutive patients-operated on between 1 April 1976 and 1 April 1977-was followed prospectively. Single or sequential saphenous vein grafts were performed with a mean of 3.2 coronary anastomoses per patient. A left ventricular aneurysmectomy was performed in 25 patients.
Results:
Complete revascularisation was achieved in 78% of the patients. Follow-up was 99.8% complete and averaged 15.4 years for the survivors. Actuarial survival after 5, 10, and 15 years was 91.4%, 79.9%, and 61.1%, respectively. The cumulative probabilities of event-free survival at 10 years were as follows: cardiac death, 87.3%; acute myocardial infarction, 84.1%; reoperation, 88.6%; coronary artery balloon angioplasty, 94.1%; angina pectoris, 48.7%; and any event, 40.8%.
Conclusions:
The results are comparable with those of the few other long-term studies that have been published. With isolated venous bypass grafting, satisfactory results can be obtained until approximately 7 years after operation. Thereafter mortality increases, as does the rate of myocardial infarction, reoperation, and balloon angioplasty.