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
