Surgical technique and operative mortality in coronary artery bypass. A postmortem analysis with castangiography.
Post-mortem analysis with castangiography was performed on 54 patients who died within 30 days of coronary artery bypass surgery. Myocardial failure was the cause of 85% of the deaths. There were 215 coronary anastomoses (4.0 +/- 1.1/patient), 24% of which were non-functioning. Most of the occlusions were due to various technical failures. The most striking features were 1) high occlusion rate (25%) in sequential vein grafts and 2) disastrous complications of coronary endarterectomies. Compared with preoperative angiographic data, only 15 (28%) of the 54 patients were found to have 'complete' revascularization, with patent grafts and all stenosed coronary arteries bypassed. The need for recognition and avoidance of technical complications is stressed: Failures of surgical technique constitute a major risk factor in coronary artery surgery.
Järvinen
A
A
Department of Thoracic and Cardiovascular Surgery, Helsinki University Central Hospital, Finland.
Männikö
A
A
Ketonen
P
P
Segerberg-Konttinen
M
M
Luosto
R
R
D000328:Adult; D000368:Aged; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000401:mortality*; D003326:Coronary Circulation; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors