Fl. Rosenfeldt et J. Wong, CURRENT EXPECTATIONS FOR SURVIVAL AND COMPLICATIONS IN CORONARY-ARTERY BYPASS-GRAFTING, Current opinion in cardiology, 8(6), 1993, pp. 910-918
The outcome of coronary artery bypass surgery is best assessed in term
s of two independent components: the operative mortality and complicat
ions on the one hand, and the late survival and relief of symptoms on
the other. The expected operative mortality rate in a particular patie
nt can be calculated with reasonable accuracy from preoperative risk f
actors. This calculation also enables results from different units to
be compared by correcting for the preoperative risk factors in the pat
ient population. Despite improvements in cardiopulmonary bypass, there
is still a low but appreciable incidence of subtle neuropsychological
changes induced by coronary artery bypass grafting. The expected long
-term results of the procedure must be determined from the results of
surgery in the past. However, allowance must be made for two new influ
ences. One is the expected improvement in the long-term results of cur
rent surgery, due to the improved longevity of currently used graft co
nduits such as the internal mammary artery. The other is the worsening
of late results of present-day coronary artery bypass grafting caused
by the greater number of preoperative risk factors in patients curren
tly accepted for surgery, such as old age, impaired left ventricular f
unction, and reoperation.