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Ann Thorac Surg 1979;28:423-428
© 1979 The Society of Thoracic Surgeons
From St. Luke's Hospital and the Department of Thoracic and Cardiovascular Surgery, The Medical College of Wisconsin, Milwaukee, WI.
* Address reprint requests to Dr. Flemma, 9800 W Blue-mound Rd, Milwaukee, WI 53226
Utilizing patient criteria published by the Veterans Administration Cooperative (VAC) Study, a cohort of 229 surgically treated patients was retrieved from the Milwaukee Cardiovascular Data Registry. These patients were all operated on by one surgeon during 1972 to 1974. Four-year survival of this group was compared with that of the medically treated cohort of 310 patients from the VAC Study. Operative mortality was included in all surgical groups.
The cumulative 4-year survival of both groups revealed a 95 to 85% advantage for surgical therapy. In patients with three-vessel disease, the cumulative survival favored surgical therapy—94% compared with 80% in the medically treated cohort—and in patients with triple-vessel disease and a normal left ventricle, surgical therapy again showed better results: 100% compared with 88%. Patients with two-vessel disease and a normal left ventricle who underwent surgical intervention had slightly better 4-year survival than those who had medical treatment—100% versus 95%—and those with two-vessel disease and an abnormal left ventricle had a 93% survival after surgical treatment compared with 84% for those with medical treatment. For patients with single-vessel disease, there was no difference in survival between the surgical and medical cohorts.
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