LONG-TERM CLINICAL OUTCOME FOLLOWING CORONARY-ARTERY BYPASS-GRAFTING FOR ISOLATED STENOSIS OF THE LEFT ANTERIOR DESCENDING CORONARY-ARTERY

Aims To detail the clinical and angiographic profile, and long-term ou tcome in consecutive patients with isolated stenosis of the left anter ior descending coronary artery undergoing bypass surgery. Methods A re trospective study of all patients (n=301) (January 1984-December 1990) and undergoing coronary artery bypass grafting for isolated left ante rior descending disease, in the Irish Republic, was performed. Surviva l was compared with that of an exact age-and gender-matched cohort. Re sults Mean age was 53 (+/-9.3) years. There were 238 (79%) males. In 2 41 (80%) patients an internal thoracic arterial bypass graft was used. Operative mortality was 1.3%. Of the 280 (93%) patients alive (16 car diac deaths) at 7.1 (+/-1.9) years, 105 (35%) had angina, 26 (9%) suff ered an interval myocardial infarction, and repeat revascularization w as required on 29 (10%). Female gender (P=0.002), pre-operative myocar dial infarction (P=0.02), significant diagonal disease (P=0.04) and po stoperative myocardial infarction (P=0.0001) were independently associ ated with survival. Females were more likely to develop congestive car diac failure (P=0.01) or postoperative angina (P=0.03) than their male counterparts. Conclusions Survivorship (97%) and event-free survival (96%) at 5 years following coronary artery bypass grafting for isolate d left anterior descending coronary artery disease is excellent and eq uivalent to an age-matched and gender-matched cohort.