VENOUS CORONARY-ARTERY BYPASS-SURGERY - A 15-YEAR FOLLOW-UP-STUDY

Background. Although the long-term results of isolated venous coronary artery bypass surgery are well known, there are few multivariate stat istical data on such patient groups. Methods and Results. We report on 428 consecutive patients, 383 men and 45 women with a mean age of 52. 6 years, who underwent isolated venous aortocoronary bypass graft surg ery with or without left ventricular aneurysm surgery between April 1, 1976, and April 1, 1977, and whom we followed prospectively. A multiv ariate analysis using the Cox regression model was performed to establ ish the determinants of long-term outcome. The hospital mortality and myocardial infarction rates were 3% and 6.3%, respectively. Complete r evascularization was obtained in 77.6%. Follow-up was 99.8% complete a nd averaged 13.4 years (range, 1.5 months to 16.6 years). Actuarial su rvival after 5, 10, and 15 years is 94.2%, 82.40/o, and 63%, respectiv ely. The cumulative probability of event-free survival for cardiac dea th, acute myocardial infarction, reintervention, and angina pectoris a t 5, 10, and 15 years, respectively, are 97.8%, 90.1%, 74.4%; 98.5%, 8 9.0% 77.4%; 97.0%, 83.0%, 62.1%; and 77.8%, 52.1%, 26.8%. Left ventric ular function and the number of vessels diseased are the independent p reprocedural predictors of cardiac survival. Obesity and hypertriglyce ridemia are preprocedural predictors of late myocardial infarction. Pr eoperative validity (Canadian Cardiovascular Society) and the number o f diseased vessels are the predictors of recurrent angina. Conclusions . We conclude that the long-term results of isolated venous bypass gra ft surgery are dependent not only on well-known preprocedural factors such as number of vessels diseased, left ventricular function, and age but also on obesity and hypertriglyceridemia.