[The midterm clinical results of myocardial revascularization with the internal mammary artery].
After a 3-year (1985-1988) experience of myocardial revascularization using internal mammary artery (AMI) grafts and after having excluded (1986) an higher operative mortality and morbidity, clinical medium-term results have been analysed. The first 144 patients discharged alive after AMI bypass surgery in 1985 were clinically evaluated, with a mean interval of 21 months from surgery (range: 5-29 months). Exercise electrocardiographic test was performed by 100 patients, and angiography repeated in 15. Actuarial survival function was estimated by Cutler-Ederer method: 2-year actuarial survival was 99.3 +/- 0.7% (94 +/- 1.8%, when operative deaths were included). Non fatal myocardial infarction occurred in 3 patients and, at follow-up, 26 were symptomatic for angina: 2 patients underwent re-operation and 2 angioplasty. Two years after AMI bypass surgery, actuarial estimate of ischemic event-free patients was 70.9 +/- 4.5% (67.7 +/- 4.5%, when operative deaths were included): 73 out of 100 exercise tests were negative for both angina and ischemia, although only 43 patients, reached maximal work load; 9 were positive for both angina and ischemia and 18 for ischemia only. All patients who underwent angiographic evaluation (15 patients, 11 of whom because of angina relapse) had AMI grafts open, while in only 4 patients all the implanted grafts were open.
Comoglio
C
C
Istituto di Medicina e Chirurgia Cardiovascolare, Università degli Studi, Torino.
Bergerone
S
S
Ottino
G
G
Del Ponte
S
S
Di Leo
M
M
Trucano
G
G
Golzio
P G
PG
Villani
M
M
Fubini
A
A
Brusca
A
A
D000368:Aged; D000787:Angina Pectoris / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000601:surgery; D009204:Myocardial Revascularization / Q000401:mortality* / Q000706:statistics & numerical data; D005082:Physical Exertion; D012008:Recurrence; D012307:Risk Factors; D016019:Survival Analysis