Simultaneous extensive extracranial and coronary revascularization. Long-term follow-up up to 13 years.
Simultaneous surgery for extensive extracranial and coronary revascularization was performed in 168 patients (mean age 61 years), from 1974 up to June 1987; 116 patients (69%) were in NYHA class III or IV, 133 (79%) had triple vessel disease and 51 (30%) had left main stem lesions. One or more previous myocardial infarctions were present in 96 patients (57%); normal preoperative left ventricular function was present in only 35%. In 22 cases, additional cardiac procedures were performed. Symptomatic extracranial disease was present in 76 patients (45%), arch vessel surgery was performed in 29 (17%) and bilateral haemodynamically significant carotid disease was present in 58 (35%). Operative mortality (3%) was mainly cardiac and operative morbidity mainly neurological (7%). Actuarial survival at 5 years (75%) and 10 years (57%) was mainly determined by the cardiac survival (87% at 5 years and 70% at 10 years), while neurological follow-up deaths were rare (neurological survival 97% at 5 years and 91% at 10 years). Late morbidity was more cardiac than neurologically determined; actuarial curves showed 72% to be free of all serious events or death at 5 years, and 47% at 10 years.
Vermeulen
F E
FE
Department of Cardiothoracic Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands.
de Geest
R
R
van den Pavoordt
H
H
Eikelboom
B
B
D000328:Adult; D000368:Aged; D002340:Carotid Artery Diseases / Q000150:complications / Q000401:mortality / Q000601:surgery*; D002561:Cerebrovascular Disorders / Q000209:etiology; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality; D003327:Coronary Disease / Q000150:complications* / Q000401:mortality / Q000601:surgery; D004691:Endarterectomy / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D015996:Survival Rate