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The Journal of Thoracic and Cardiovascular Surgery, Vol 82, 383-390, Copyright © 1981 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Long-term results following coronary bypass operation. Importance of preoperative actors and complete revascularization

AJ Buda, IL Macdonald, MJ Anderson, HD Strauss, TE David and ND Berman

The initial 102 patients who underwent aorta-coronary bypass grafting between 1969 and 1971 were followed for a mean of 96 months (minimum follow-up 7 years). Preoperative variables predictive of survival at 5 years were stability of angina, previous heart failure, and left ventricular function. Stability of angina, previous heart failure, previous myocardial infarction, and smoking were important predictors of symptomatic status at 5 years. At operation, 62 patients had anatomic or technically complete revascularization, whereas 40 had incomplete revascularization. There was a significantly improved survival rate in those patients who were completely revascularized. The 5 year survival rate was 84% for completely revascularized patients compared to 96% for incompletely revascularized patient (p less than 0.02). This improvement in survival was continued to 9 years. There was also a significant improvement in asymptomatic status of the completely revascularized patients compared to the incompletely revascularized patients. At 2 years, 75% of the completely revascularized subjects were asymptomatic compared to 45% of the incompletely revascularized patients. However, this difference disappeared after 5 years. Thus complete myocardial revascularization is superior to incomplete revascularization in terms of survival and asymptomatic state. Preoperative variables may be useful in predicting postoperative results.

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