Long-term results following coronary bypass operation. Importance of preoperative actors and complete revascularization.

The initial 102 patients who underwent aorta-coronary bypass grafting between 1969 and 1971 were followed for a mean of 96 months (minimum follow-up 7 years). Preoperative variables predictive of survival at 5 years were stability of angina, previous heart failure, and left ventricular function. Stability of angina, previous heart failure, previous myocardial infarction, and smoking were important predictors of symptomatic status at 5 years. At operation, 62 patients had anatomic or technically complete revascularization, whereas 40 had incomplete revascularization. There was a significantly improved survival rate in those patients who were completely revascularized. The 5 year survival rate was 84% for completely revascularized patients compared to 96% for incompletely revascularized patient (p less than 0.02). This improvement in survival was continued to 9 years. There was also a significant improvement in asymptomatic status of the completely revascularized patients compared to the incompletely revascularized patients. At 2 years, 75% of the completely revascularized subjects were asymptomatic compared to 45% of the incompletely revascularized patients. However, this difference disappeared after 5 years. Thus complete myocardial revascularization is superior to incomplete revascularization in terms of survival and asymptomatic state. Preoperative variables may be useful in predicting postoperative results.