title: Six-year clinical and angiographic follow-up of patients with previously documented complete revascularization.
abstract: Relatively little information is available concerning the late clinical and angiographic status of patients with initially successful coronary bypass surgery. From 72 patients who had angiography 1 year after bypass surgery, we restudied at 6 years 19 patients with complete revascularization. At 1 year, 14 patients were asymptomatic and five had minimal anginal symptoms. Five years later, eight patients had redeveloped angina, and 11 retained their initial postoperative status. Overall graft patency at 6 years was 86%; 52% of the patients had atherosclerotic progression to > or = 70% luminal narrowing in a major unbypassed vessel or in a major vessel distal to bypass. The patients with unchanged symptoms all had patent grafts, while 11 of the 15 (73%) grafts were patent in patients with symptomatic deterioration (NS). However, progression of coronary disease occurred in seven of eight patients (88%) with worsened symptoms, as opposed to three of 11 patients with unchanged symptoms (P < 0.05). We conclude that late symptomatic deterioration following coronary bypass surgery is common, and that it usually reflects progression of coronary artery disease.
authors.affiliation: Cardiology Division, Stanford University Medical Center, Stanford, California 94305, USA.
authors.forename: E W
authors.initials: EW
authors.lastname: Robert
authors.forename: D F
authors.initials: DF
authors.lastname: Guthaner
authors.forename: L
authors.initials: L
authors.lastname: Wexler
authors.forename: E L
authors.initials: EL
authors.lastname: Alderman
mesh_terms: D000787:Angina Pectoris / Q000401:mortality / Q000601:surgery; D017023:Coronary Angiography / Q000379:methods*; D001026:Coronary Artery Bypass / Q000379:methods* / Q000401:mortality; D003324:Coronary Artery Disease / Q000401:mortality / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000601:surgery; D016019:Survival Analysis; D013997:Time Factors