Summary of a consensus concerning death and ischemic events after coronary artery bypass grafting.

The early and long-term results of myocardial revascularization are reviewed for four unidentified community hospitals, for Katholieke Universiteit (Leuven, Belgium), and for the University of Alabama at Birmingham at two different times. After operation, approximately 77% of patients are free from all ischemic events at 5 years and nearly 50% are free at 10 years. Over 90% of patients survive 5 years, and approximately 80% survive 10 years. Some of the incremental risk factors for early death after operation include older age; degree of left ventricular dysfunction; hemodynamic instability at the time of operation; recent myocardial infarction; number of diseased coronary vessels; associated mitral incompetence, ventricular aneurysm, or ventricular tachycardia; longer aortic cross-clamp time; and non-use of the internal mammary artery for revascularization. The number of diseased coronary arteries and the aggressiveness of the atherosclerotic process, degree of left ventricular dysfunction, older age, and non-use of the internal mammary artery are risk factors for reduced long-term survival.