Life Expectancy after Coronary Artery Bypass Surgery

Summary

The life expectancy of 2 subgroups of a series of 1571 consecutive patients with saphenous vein coronary artery bypass grafts is compared to that reported in the literature for 2 groups of medically treated patients.

Having excluded patients with left main coronary artery obstruction, the remaining 1395 surgical patients with single, double, and triple vessel disease are compared to 1093 medically treated patients as reported by Lichtlen (8): Five-year survival was 94.4% in the surgical group (s) as compared to 71.4% in the medical group (m). The number of stenosed vessels had much less influence on survival in the surgical than in the medical group: 5-year survival for patients with single vessel disease was 97.1 % 4s> vs. 84.6% (m), for patients with double vessel disease 93.5% (S) vs. 76.0% (m), and for patients with triple vessel disease 93.6% (s) vs. 52.1% (m).

In order to compare a group of medically treated patients with a more favorable prognosis, as reported by Read (11), vue subjected our surgically treated patients to the selection criteria of the Veterans Administration Cooperative (VA) study. Women as well as patients with unstable angina and ventricular aneurysms were excluded: Overall 4-year survival for the remaining 992 surgically treated patients was 96% as compared to 83% for the medically treated VA-group. For patients with single vessel disease .the survival was 98% in both the surgical and the medical groups, for patients with double vessel disease 97% (s) vs. 87% (m), for patients with triple vessel disease 93% (s) vs. 73% (mt, and for patients with left main coronary artery stenosis 95% (s) vs. 64% (m).

These data suggest, that the distinct increase in mortality with the increasing number of coronary arteries obstructed, as seen in medically treated patients, is largely abolished by operative revascularization.

Key Words

Coronary heart disease - Medical treatment - Surgical treatment - Comparison of survival rates