THE RELATIONSHIP BETWEEN PREOPERATIVE CORONARY ANGIOGRAPHY AND CLINICAL OUTCOME OF AORTOCORONARY BYPASS-SURGERY

Two hundred and fifty preoperative coronary cineangiograms were review ed. All observed stenoses were evaluated with regard to location, seve rity and suitability for bypass grafting. The angiographic prediction for a successful surgical result was classified as ''doubtful'', ''acc eptable'', ''good'' and ''very good''. This was compared with the clin ical result following surgery. All patients were operated on during th e period March 1983 and November 1985. The mean observation time with regard to subjective improvement was 2.7 years (range 1.6-4.3). In the group ''doubtful'', containing 7 patients, 6 became free of symptoms or much improved, whereas one patient was unchanged. This was better t han expected. In the group which was estimated to be ''very good'', in cluding altogether 54 patients, approximately the same degree of impro vement was achieved as in the other groups. An exercise test was perfo rmed 4.9 years (range 3.6-6.7) postoperatively. The distribution of po sitive exercise stress tests indicating remaining coronary ischemia, w as almost equally divided in the four groups, except for the group ''v ery good'' where the share of positive tests was less. It is concluded that predicting the result of the operation from preoperative angiogr ams may be difficult, and unreliable in the groups where the results a re predicted to be ''acceptable'' or ''doubtful''.