The influence of residual disease after coronary bypass on the 5-year survival rate of 1274 men with coronary artery disease.

Publisher Website
Google Scholar
Abstract
To determine the independent influence of the extent and site of residual disease on late survival, the fate of 1448 consecutive patients who had coronary artery bypass surgery during 1968-1974 was analyzed. There were 1274 males, mean age 53.4 .+-. 8 yr (range 24-75 yr). Females were excluded from further analysis. Patients (226, 17.7%) had 1-vessel disease, 492 (38.6%) had 2-vessel disease, 408 (32.0%) had 3-vessel disease and 148 (11.6%) had left main stenosis. Survival was determined at a follow-up of at least 5 yr. Survival data were analyzed by Kaplan-Meier survival curves for the patients with 2- and 3-vessel disease according to the extent of residual disease. For patients with 2-vessel disease and good ventricular function, survival was similar at 5 yr, 89.1 and 87.7% for no and 1 residual lesion; for those with 3-vessel disease and good ventricular function, it was 92.0, 83.4 and 75.0% for no, 1 and 2 residual lesions, respectively. With poor ventricular function, the corresponding results were 83.1, 72.5 and 23.1%. The Cox multivariate analysis technique was used to analyze the influencee of age at operation, number of vessels diseased preoperatively, preoperative left ventricular function, period of surgery, and the number and site of residual lesions after operation. Residual disease, age at operation and left ventricular function were the most important variables affecting survival of patients with 2- and 3-vessel disease. Residual lesions of the left anterior descending or circumflex coronary arteries were the most important predictors of survival; residual lesions of the right coronary artery exerted a lesser influence. The greatest benefit in terms of improved survival may come from the first 2-3 grafts placed.

This publication has 3 references indexed in Scilit: