CHANGING INDICATIONS FOR CORONARY-ARTERY BYPASS-SURGERY FROM 1985 TO 1992

We analyzed the changing use of coronary artery bypass grafting in our institution during the years from 1985 to 1992. All clinical paramete rs indicating an increased perioperative risk for the surgical interve ntion increased during the study period (increased percentage of old p atients, females, patients with severe coronary artery disease (high m odified Gensini-index or triple-vessel disease), and left main stenose s). During a 2-year follow-up there was a constant proportion of patie nts with a good postoperative clinical result; perioperative mortality as well as global and cardiac 2-year mortality showed no significant changes. Despite an increased proportion of patients with higher perio perative risk the acute and long-term results of coronary artery bypas s surgery in our study were quite satisfactory. This must be attribute d to improvements in operative techniques, improved personal skills of the surgeons, and improvements in perioperative treatment and critica l care.