Aorta-coronary artery saphenous vein bypass surgery: clinical and angiographic results
Assad-Morell, J.L.; Frye, R.L.; Connolly, D.C.; Davis, G.D.; Pluth, J.R.; Wallace, R.B.; Barnhorst, D.A.; Elveback, L.R.; Danielson, G.K.
Mayo Clinic Proceedings 50(7): 379-386
1975
ISSN/ISBN: 0025-6196 PMID: 1080228 Document Number: 84815
In a series of 500 consecutive patients undergoing aorta-coronary artery saphenous vein bypass surgery, operative mortality was 2.5% (1% with one-vessel disease, 2% with two-vessel disease, and 3% with three-vessel disease). Transmural myocardial infarction occurred within 30 days after operation in 67 cases (13%) and caused 10 of the 16 deaths in that period. Among 484 patients followed 1 to 58 months (median, 26 months), there have been 20 deaths. Of the 464 survivors, 65% had complete relief of angina, 24% were improved, and 11% were unimproved. In 162 patients who underwent postoperative graft angiography between 1 and 42 months after surgery, a strong positive relationship existed between clinical response and completeness of myocardial revascularization as defined by the presence of a patent graft to all major coronary arteries with greater than 50% stenosis. A similar relationship was found between postoperative multistage treadmill exercise response and completeness of myocardial revascularization. Thus, 82% of patients completely revascularized were asymptomatic at the time of postoperative graft visualization, and 91% had a negative treadmill exercise response.