Literature DB >> 10226409

Coronary artery bypass grafting. Late result of actual 10-years follow-up in 376 patients.

K Takazawa1, Y Hosoda, T Yamamoto, S Kawasaki, S Sasaguri.   

Abstract

OBJECTIVES: The aim of this study was to analyze the long-term results of coronary artery bypass grafting in Japanese patients who were followed more than 10 years after surgery, and, without resorting to actuarial methods, to determine the factors that influence long-term survival. SUBJECTS AND METHODS: From January 1984 through December 1986, 376 patients received coronary artery bypass grafting at the Department of Cardiothoracic Surgery of Juntendo University; it is these patients who comprise the subject of this study. Of the 376 patients, 328 were males (87.2%) and the mean patient age was 58.5 years (range: 32 to 78 years). Single vessel disease was present in 36 patients (10.8%), double vessel disease in 89 patients (26.7%), triple vessel disease in 150 patients (45.0%) and 58 patients (17.4%) with 50% of more stenosis of the left main coronary artery. The mean number of grafts used was 2.3 grafts per patient, while internal thoracic artery conduits were used in 66 patients (17.6%).
RESULTS: The 10-year survival rate for the entire series of patients was 81.4%. Patients receiving internal thoracic artery grafts had a 10-year survival rate of 94.0%, superior to the 78.0% rate found in patients who received only saphenous vein grafts. Other risk factors associated with reduced survival rates, besides non-use of internal thoracic artery, were: advanced age, diabetes mellitus, hypertension, presence of left main coronary artery disease, and severely impaired left ventricular function. The 10-year cardiac event free rate in the total group was 80.4%. Of 70 patients who died during the follow-up period, 19 deaths were due to cardiac causes (27.1%), 19 due to malignant neoplasm (27.1%) and 13 due to the cerebral vascular accident (18.6%).
CONCLUSIONS: Univariate analysis revealed that: the use of only saphenous vein grafts (P = 0.0055), advanced age (P < 0.0001), diabetes mellitus (P < 0.0001), hypertension (P = 0.0282), presence of left main coronary artery disease (P = 0.0140), and severely impaired left ventricular function (P = 0.0075) are associated with reduced survival in patients undergoing coronary artery bypass grafting in this cohort of patients.

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Mesh:

Year:  1999        PMID: 10226409     DOI: 10.1007/bf03217953

Source DB:  PubMed          Journal:  Jpn J Thorac Cardiovasc Surg        ISSN: 1344-4964


  14 in total

1.  Long-term follow-up of medically treated patients with coronary artery disease--I. Incidence of major cardiac events and its risk factors in Japanese with coronary artery disease.

Authors:  S Hosoda; T Iino; H Yasuda; T Takishima; Y Ito; S Kimata; Y Mizuno; M Inoue; T Kuzuya; F Kajiya
Journal:  Jpn Circ J       Date:  1990-03

2.  Long-term benefits of internal thoracic artery-coronary artery bypass in Japanese patients.

Authors:  S Kitamura; K Kawachi; S Taniguchi; T Kawata; S Kobayashi; H Nishioka; K Mizuguchi; K Niwaya; Y Kameda; H Sakaguchi
Journal:  Jpn J Thorac Cardiovasc Surg       Date:  1998-01

3.  The left internal mammary artery: the graft of choice.

Authors:  J E Okies; U S Page; J C Bigelow; A H Krause; N W Salomon
Journal:  Circulation       Date:  1984-09       Impact factor: 29.690

4.  Comparison of late changes in internal mammary artery and saphenous vein grafts in two consecutive series of patients 10 years after operation.

Authors:  C M Grondin; L Campeau; J Lespérance; M Enjalbert; M G Bourassa
Journal:  Circulation       Date:  1984-09       Impact factor: 29.690

Review 5.  Long-term results of coronary bypass surgery. Analysis of 1698 patients followed 15 to 20 years.

Authors:  G M Lawrie; G C Morris; N Earle
Journal:  Ann Surg       Date:  1991-05       Impact factor: 12.969

6.  Twelve-year follow-up of survival in the randomized European Coronary Surgery Study.

Authors:  E Varnauskas
Journal:  N Engl J Med       Date:  1988-08-11       Impact factor: 91.245

7.  Long-term prognosis in 990 medically treated Japanese patients with coronary artery disease.

Authors:  S Nishiyama; K Kato; S Nakanishi; A Seki; H Yamaguchi
Journal:  Jpn Heart J       Date:  1993-09

8.  Bypass surgery with the internal mammary artery graft: 15 year follow-up.

Authors:  A Cameron; H G Kemp; G E Green
Journal:  Circulation       Date:  1986-11       Impact factor: 29.690

9.  Seventeen-year experience with bilateral internal mammary artery grafts.

Authors:  D L Galbut; E A Traad; M J Dorman; P L DeWitt; P B Larsen; P A Kurlansky; J H Button; J M Ally; T O Gentsch
Journal:  Ann Thorac Surg       Date:  1990-02       Impact factor: 4.330

10.  Late results of coronary artery bypass surgery with maximal follow-up of 7 years: analysis of determinants affecting late survival.

Authors:  Y Hosoda; M Nukariya; M Watanabe; S Sasaguri; M Kazui; M Tahara; T Watanabe; T Sato; M Goto; K Takazawa
Journal:  Cardiovasc Surg       Date:  1993-08
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  3 in total

1.  Bypass graft material and myocardial protective procedure in combined coronary artery bypass grafting and valve surgery.

Authors:  H Fujii; H Otani; T Oka; Y Hino; H Fujiwara; T Sumida; M Osako; H Imamura
Journal:  Jpn J Thorac Cardiovasc Surg       Date:  2000-09

2.  Is diabetes mellitus a major risk factor in coronary artery bypass grafting? The influence of internal thoracic artery grafting on late survival in diabetic patients.

Authors:  T Yamamoto; Y Hosoda; K Takazawa; I Hayashi; H Miyagawa; S Sasaguri
Journal:  Jpn J Thorac Cardiovasc Surg       Date:  2000-06

Review 3.  Morphological characteristics of coronary atherosclerosis in diabetes mellitus.

Authors:  Renu Virmani; Allen P Burke; Frank Kolodgie
Journal:  Can J Cardiol       Date:  2006-02       Impact factor: 5.223

  3 in total

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