Influence on late survival of graft status and degree of correction following aortocoronary bypass graft surgery

Abstract

INFLUENCE ON LATE SURVIVAL OF GRAFT STATUS AND DEGREE OF CORRECTION FOLLOWING AORTOCORONARY BYPASS GRAFT SURGERY Jacques Hermann, MD; Frederic0 Corbara, MD; Jacques Lespkance, MD; Martial G. Bourassa, MD, FACC; Lucien Campeau, MD, FACC, Montreal Heart Institute, Montreal, Quebec, Canada In 807 patients (pts) having pure aortocoronary bypass graft surgery among our first 1000 pts, the 6 year late survival (excluding deaths within the first month) was not influenced by the degree of correction. It was suspected that this might be explained by the high graft attrition of 25% during the first year. Survival was therefore determined after the first year in 65 pts in whom correction was still optimal as determined by angiographic studies obtained 1 year after surgery (all coronary arteries with stenosis >,70% successfully bypassed), and in 267 pts with incomplete correction at angiography (N156) or at the time of surgery (Nlll). The 6 year late survival (6 yr LS) was 98.4+3.2% for the pts with optimal correction as compared to 83.2+6.4% for pts with incomplete correction (pcO.025). The 6 yr LS (after the first yeas) was 94.1C4.6% in 113 pts in whom all grafts were patent, as compared to 70.4?16.8% in 38 pts whose grafts were all occluded (p<O.Ol). 40 pts with at least 1 graft patent and 1 occluded had a 6 yr LS of 87.2+12.0%. In conclusion, late survival is greatly influenced by the degree of correction and graft status 1 year after surgery. LONG-TERM BENEFITS OF MYOCARDIAL RBVASCULARIZATION 04R) Denis H. Tyras, MD; Hendrick 8. Barner, MD, FACC; George C. Kaiser, MD, FACC; John E. Codd, MD; Hillel Laks, MD, FACC; Vallee L. Willman, MD, FACC. Saint Louis University, St. Louis, MO. From January, 1970 through June, 1977, 1541 patients received isolated coronary artery bypass grafts. Operative mortality was 2.6%. Actuarial five-year survival was 92.8%. Cumulative graft patency rates were 92.3% at one month, 85.8% at one year, 82.4% at three years and 70.5% at five years. Survival rate for single vessel disease was 97.7%. In multivessel disease, survival increased with the number of grafts used: single (90.6X), double (91.7X), triple or more (92.9%). Late myocardial infarction occurred in 3.3% of patients. Not only does MR appear to be of longterm benefit in relief of angina, but also it appears to offer favorable results in longevity and low incidence of late myocardial infarction. MONDAY, MARCH 6, 1978