Direct Coronary Artery Surgery for One Year Without an Operative Death: 196 Consecutive Cases

Abstract

A one-year series of 196 consecutive patients who underwent coronary artery bypass operation without a hospital death is presented; included are patients who had associated intracardiac procedures. Many patients had impairment of one or more portions of their left ventricular wall. Of the 196 patients, 194 (99%) have been followed up by questionnaire 6 to 18 months postoperatively. Grading of results has been according to degree of symptom relief and level of postoperative activity. Ninety-five percent of the 194 have improved after operation, and 89% are experiencing good or excellent results. There have been 5 late deaths. The factors pertaining to the management of these patients in the preoperative, operative, and postoperative periods that have made these results possible are indicated. The criteria used in our attempt to properly select patients with ventricular impairment are also cited. Most of the patients who had a less than optimal outcome following the operative procedure were noted at operation to have severe diffuse coronary atherosclerosis.