Between May 1969, and May 1973, the procedure of aortocoronary bypass (ACB) was performed in 242 patients. A total of 42 patients (17 percent) had preinfarction angina or early acute myocardial infarction and others exhibited severe unremitting angina pectoris. There were 30 women (12.5 percent). The over-all operative mortality rate was 5.7 percent and the intraoperative infarction rate was 7 percent. On follow-up of the entire group of patients, 89 percent have remained angina free and at restudy 85 percent have patent grafts. Comparison of pre- and postoperative cardiac function and hemodynamics showed that 50 percent of patients, over all, had some improvement. This change in cardiac function was unrelated to the extent of intraoperative graft flow or number of grafts. In the preinfarction group there was no operative death but 20 percent developed intraoperative infarction. In the course of one to 4 years follow-up, 41 of these patients have remained angina free and have not had late myocardial infarction. Twenty-four of these patients have been restudied at 4 to 48 months after the operation and all but one (95 percent) have patent grafts. Female patients had an operative mortality rate of 10 percent, an intraoperative infarction rate of 18 percent, and only 65 percent have remained angina free at follow-up. Of 14 female patients studied postoperatively, only 64 percent have patent grafts. Three females (11 percent) developed myocardial infarction 10 days to 3 months after the operation and one has died. As these results indicate, the procedure of ACB produces a satisfactory long-term result in patients with preinfarction and chronic intractable angina. In women, however, the procedure has less satisfactory early and long-term results.
|Original language||English (US)|
|Number of pages||10|
|State||Published - Dec 1974|
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