Multiple Vessel Coronary Disease Research Articles

Long-Term Follow-up of Sequential Aortocoronary Venous Grafts

In 1972 we reported myocardial revascularization of 130 patients using multiple sequential aortocoronary anastomoses to a single saphenous vein [1]. Of the 122 survivors described in that report, 121 (99%) have been followed an additional 3 years. Twelve deaths occurred during the interval. The 110 currently followed patients represent 290 anastomoses; 54 have been studied angiographically since operation. Angiographic patency at 3 years in the studied group (18) was 70%. These figures exceed our follow-up data for 135 patients revascularized during the same period using individual vein grafts. Comparison of life table survival curves demonstrates this result. We believe the improved patency and decreased operating time that have resulted from employing this technique have outweighed the likelihood of a proximal stenosis causing closure of the whole graft system. We continue to use this technique in combination with internal mammary artery grafts in the management of multiple-vessel coronary disease. Good early results using this technique have been reported by other authors [2, 3, 5].

The Purkinje-muscle junction: A determinant of proximal bundle branch action potential duration

The Purkinje-muscle junction: A determinant of proximal bundle branch action potential duration

Transient ST-segment in unstable angina. Clinical and hemodynamic significance.

The significance of the direction of the ST-segment shifts on the 12-lead electrocardiogram was evaluated in 82 consecutive patients with unstable angina. Eighteen patients with ST-segment elevation (group I) were compared with 64 patients with ST-segment depression (group II). There was no difference between group I and group II with regard to age, sex, or history of previous myocardial infarction. There also was no difference in the angiographic extent, location or severity of the coronary artery disease, collaterals, or resting hemodynamics. A larger proportion of patients in group I presented with recent onset angina. Life-threatening arrhythmias were more frequent in group I but were uncommon in both groups. A normal resting electrocardiogram was associated with normal ventricular function in both group I and group II but was associated with single vessel disease only in group I. An abnormal resting electrocardiogram was associated with multiple coronary vessel disease and abnormal ventricular function in both groups. Single vessel disease was encountered twice as frequently in group I but this difference was not statistically significant. Left main coronary artery disease was found only in group II.