[Five years (1995-2000) of coronary artery bypass surgery at the Odense University Hospital].
BACKGROUND
A large-scale Danish study on late outcomes after coronary artery bypass surgery (CABS) has never been done. We therefore did a retrospective study and follow-up of 2,333 patients, accounting for 2,361 consecutive CABS operations over a five-year period.


METHODS
The material consisted of 23.5% women and 76.5% men. The patients' median age was 63 years (32-85 years). The rate of response to the questionnaire was 95.3%. The median observation time was 26 months (3-63 months). In 94% of the patients, primary CABS had been undertaken, and 6% were reoperations. Ninty-three percent were elective operations, and 7% were acute. The risk score estimated 20% of the patients to be in high-risk groups, 22% in the 5% group and 53% in the low-risk group. There was three-vessel disease in 68% and left main stenosis in 24%. The EF was normal in 73% of the patients, while 4% had EF <30%.


RESULTS
The total early mortality rate was 3%, the primary elective CABS rate was 2.6%, and we found a statistically significant higher mortality for elective reoperations (5.9%) and for acute CABS (7%). Comparison with the Danish background population indicates a better survival rate for the CABS patients. One-third developed atrial flutter or atrial fibrillation. Reoperation for bleeding was done in 6.9% and for mediastinitis 1.9%. About 10% were readmitted because of various complications. In the observation period, 99 patients (7,2%) died. Patients with EF <30% and those undergoing reoperations had a statistically significant higher late mortality rate. About 20% suffered from recurrent angina in the observation period, one-fourth had wound healing of the graft leg and 96% did not regret the operation.


CONCLUSIONS
Apart from the rather high reoperation rate because of bleeding and the prolonged healing time of the graft leg, these results as well as the prognostic value of CABS in selected patient groups justifies the coronary artery bypass graft operation as a good treatment for angina pectoris.
Petersen
Henrik Ømark
HØ
Odense Universitetshospital, Thoraxkirurgisk Afdeling T. omark@dadlnet.dk
Gregersen
Nanna
N
Clausen
Betina
B
Andersen
Lars Ib
LI
D000293:Adolescent; D000328:Adult; D000368:Aged; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality / Q000592:standards; D017558:Elective Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis; D011379:Prognosis; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome