Eleven-year results of coronary artery bypass surgery
Chu, S.H.; Hung, C.R.; Wang, S.S.; Tsai, C.H.; Yang, Y.J.; Tseng, C.D.; Liau, C.S.; Huang, P.J.; Tseng, Y.Z.; Lee, Y.T.
Journal of the Formosan Medical Association 86(11): 1161-1167
1987
ISSN/ISBN: 0371-7682 PMID: 3502134 Document Number: 299064
Coronary artery bypass surgery was performed in 285 patients at the National Taiwan University Hospital (NTUH) from October 1973 to February 1984. The ages ranged from 30 to 76, with a mean of 55 years. Eighty-seven percent were male and 13% female. Excluding those patients with associated valvular surgery, left ventricular aneurysm resection, or concomitant repair of ventricular septal rupture, isolated coronary artery bypass grafting (CABG) was performed in 246 patients. The early mortality was 7.7%. Seventy nine percent of the patients belonged to New York Heart Association (NYHA) class III or IV, 70% suffered from hypertension, 55% showed previous myocardial infarction on the electrocardiogram, and 29% suffered from diabetes mellitus. All these associated diseases would increase the operative risk and were more popular in our patients than in western series. The actuarial survival rate after CABG was 95% at 5 years and 88% at 11 years in one-vessel disease, 84% at 5 and 11 years in two-vessel disease, and 80% at 5 years and 57% at 10 years in three-vessel disease. Significantly better survival was noted in patients with normal left ventricular end diastolic pressure than those with abnormal pressure. Better results were also obtained from non-diabetic (non-DM) patients than from diabetic ones. Restudy left ventriculography showed significant improvement of the ejection fraction with a preoperative value of 0.58 and a postoperative value of 0.66. After a follow-up of 49.3 months on the average, 80% of the patients showed no angina pectoris, and only 2.5% failed to improve. The others had less frequent attacks of angina, and fewer symptoms during exercise, and needed less use of anti-anginal medication. We suggest that those patients with symptoms compromising their life-style be operated. The present study shows that CABG can serve to relieve angina pectoris, improve left ventricular function, and possibly prolong life in patients with multiple vessel disease.