[Are the long-term results of venous aortocoronary bypass procedures really so bad? A prospective 13-year-long study of 428 patients].
OBJECTIVE
To assess the long-term results of coronary surgery using venous bypasses.


METHODS
Prospective study.


METHODS
St. Antonius Hospital, Nieuwegein, the Netherlands.


METHODS
In 446 successive patients subjected to coronary surgery between 1 April 1976 and 1 April 1977, a complete long-term follow-up study was carried out after an average of 11.5 years (1.5 months-14.3 years).


RESULTS
The peroperative mortality was 3%, a peroperative myocardial infarction occurred in 6.3% and complete revascularization was achieved in 77.6% of the patients. In 90 of 100 patients selected at random, cardiac catheterization was performed 13.5 months on average after the operation. The patency of the single grafts was 89.8%, that of the side-to-side and end-to-side anastomoses of the sequential grafts was 90.4% and 83%, respectively. Mortality, myocardial infarction, necessity of a second operation and angina pectoris occurred with low frequency during the first five years after the operation. Subsequently, complications increasingly occurred. Ten years after the operation 18.8% of the patients had died, 11.9% had suffered a myocardial infarction, 13.4% had been subjected to a second operation and 6.4% to balloon angioplasty, while 46.4% had once more developed angina pectoris. Thirteen years after the operation 29% of the patients had remained completely free from cardiac problems.


CONCLUSIONS
Although arterial bypasses have been increasingly used in recent years, an indication for the use of venous transplants will continue to exist in the future, also, for certain groups of patients (those younger than 50 or older than 75 years). Our study clearly shows that with venous bypasses, also, satisfactory long-term results can be obtained.
van Brussel
B L
BL
Afd. Cardiologie, St. Antonius Ziekenhuis, Nieuwegein.
Plokker
H W
HW
van den Bergh
E J
EJ
Ernst
J M
JM
Knaepen
P J
PJ
Vermeulen
F E
FE
D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D001026:Coronary Artery Bypass / Q000401:mortality; D005260:Female; D006334:Heart Function Tests; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011183:Postoperative Complications / Q000209:etiology; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D012501:Saphenous Vein / Q000637:transplantation; D013997:Time Factors; D016277:Ventricular Function, Left
Zijn de lange-termijnresultaten van veneuze aortocoronaire overbruggingsoperaties wel zo slecht? Een prospectief onderzoek over 13 jaar bij 428 patiënten.