[Results of venous aortocoronary bypass with a minimum follow-up of more than 10 years]

Abstract

The results of saphenous vein coronary bypass alone were assessed in 126 patients operated between 1970 and 1972 with a postoperative follow-up period of 10 to 12 years. Spontaneous or unstable angina was observed in 72% and incapacitating effort angina in 27.7%. An average of 1.8 grafts per patient was carried out but revascularisation remained incomplete in 51.6% of cases. The early postoperative mortality was 1.58%; the early postoperative infarct rate was 12.7%. There were 47 late deaths, most of which were of cardiac origin (53.2%) or due to cerebrovascular accidents (12.8%). Actuarial survival studies showed an annual mortality rate of 3.2%. The overall 10 to 12 year survival rate was 68.4. The secondary infarction rate was 13.7%, an annual rate of less than 1.5%. Control coronary angiography was carried out in 112 patients; 78% of the grafts remained patent at 2 years. Age (p less than 0.008), basal ECG changes (p less than 0.003) and left ventricular function (p less than 0.05) were significant prognostic factors for survival. One year after surgery, 63.5% of patients were angina free. Thereafter, the annual recurrence rate for angina was 3.1%. After 10 years, 35.4% of patients remained free of angina. A statistical analysis of the factors influencing the recurrence of angina showed that the number of coronary stenoses (p less than 0.02) and the quality of revascularisation (p less than 0.001) were significant factors. After an average follow-up of 75.7 months, 9 patients were reoperated using the internal mammary to revascularize the left anterior descending artery. Sixty per cent of the operated patients were able to return to work.