[Surgical treatment of coronary heart disease].
The goal of coronary surgery in stable angina pectoris is relief of symptoms and improvement of prognosis, whereas in unstable angina pectoris the main purpose is the prevention of infarction. In 'mechanical' complications of infarction, surgery is undertaken to treat severe congestive heart failure or cardiogenic shock. Prophylactic operations in asymptomatic patients are generally recommended in three-vessel disease, left main-stem stenosis and critical stenosis of the left anterior descending artery with the purpose to reduce the risk of myocardial infarction and to improve survival. Early surgically mortality was about 1% some years ago, but is actually slightly higher, mainly due to selection of high-risk patients since the introduction of PTCA. Late mortality is about 5% after one year and about 25% after ten years. The early patency rate of vein grafts is more than 90% and decreases about 5% per year, whereas results with arterial grafts are even better. Early surgical mortality in patients with mechanical complications is very high (40 to 50%) in the acute stage of infarction; results in the chronic stage are much better (5 to 10%).
Departement Chirurgie, Kantonsspital Basel.
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Grädel
D003327:Coronary Disease / Q000601:surgery*; D006322:Heart Aneurysm / Q000601:surgery; D006341:Heart Rupture / Q000601:surgery; D006801:Humans; D009204:Myocardial Revascularization / Q000379:methods* / Q000401:mortality / Q000706:statistics & numerical data; D012307:Risk Factors
Chirurgische Behandlung der koronaren Herzkrankheit.