The relationship between preoperative coronary angiography and clinical outcome of aortocoronary bypass surgery.
Two hundred and fifty preoperative coronary cineangiograms were reviewed. All observed stenoses were evaluated with regard to location, severity and suitability for bypass grafting. The angiographic prediction for a successful surgical result was classified as "doubtful", "acceptable", "good" and "very good". This was compared with the clinical result following surgery. All patients were operated on during the period March 1983 and November 1985. The mean observation time with regard to subjective improvement was 2.7 years (range 1.6-4.3). In the group "doubtful", containing 7 patients, 6 became free of symptoms or much improved, whereas one patient was unchanged. This was better than expected. In the group which was estimated to be "very good", including altogether 54 patients, approximately the same degree of improvement was achieved as in the other groups. An exercise test was performed 4.9 years (range 3.6-6.7) postoperatively. The distribution of positive exercise stress tests indicating remaining coronary ischemia, was almost equally divided in the four groups, except for the group "very good" where the share of positive tests was less. It is concluded that predicting the result of the operation from preoperative angiograms may be difficult, and unreliable in the groups where the results are predicted to be "acceptable" or "doubtful".
Lundbom
J
J
Department of Surgery, University Hospital of Trondheim, Norway.
Ystgaard
B
B
Bolz
D
D
Myhre
H O
HO
Levang
O W
OW
D000328:Adult; D000368:Aged; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000601:surgery; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D011379:Prognosis; D016896:Treatment Outcome