Refinements in Coronary Artery Surgery Contributing to Improved Survival

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Abstract
Reviews of the literature and controlled studies of medical versus surgical treatment of coronary artery disease that include surgical results from 3 or 4 years ago may not be pertinent to therapeutic decisions made today. The results in our patients operated during 2 two-year periods (1974-1976, Group I and 1976-1978, Group II) are compared. The Group II patients had more severe coronary artery disease. They had significantly more grafts per patient (p <.001), their cardiopulmonary bypass time was significantly reduced (p < .001), they received less inotropic support {p < .005) and spent less time in the intensive care unit (p < .001). There was a significant decrease in the overall perioperative mortality (30-day) in the patients of Group II (p < .055). The second two-year period coincided with the adoption of refinements in the intraoperative preservation of myocardium and also in surgical technique. These refinements are discussed in detail.

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