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Ann Thorac Surg 1989;47:595-599
© 1989 The Society of Thoracic Surgeons

Articles

Fifteen-year results of coronary artery bypass for isolated left anterior descending coronary artery disease

Duncan A. Killen, MD*, Malcolm Arnold, MD, David R. McConahay, MD, Suchint Wathanacharoen, MD, William A. Reed, MD

Mid America Heart Institute of Saint Luke's Hospital, Kansas City, Missouri, USA

Accepted for publication November 24, 1988.

* Address reprint requests to Dr Killen, Medical Plaza II-50, 4320 Womall Rd, Kansas City, MO 64111.

During 1971 through 1975, 266 patients underwent primary coronary artery bypass grafting for occlusive disease confined to the left anterior descending coronary artery. Actuarial survival at 15 years was 72.7% with 60% of survivors being free from angina. Although the cause of death was cardiac related in 50% of the patients who died, survival was comparable with that of an age-matched and sex-matched general population. During follow-up, 48 secondary or tertiary repeat coronary artery bypass as well as 44 percutaneous transluminal coronary angioplasty procedures were performed. Acute event-free status (freedom from acute myocardial infarction, repeat coronary artery bypass grafting, percutaneous transluminal coronary angioplasty, or death) persisted at 15 years in 43.2% of patients. The differences in survival when patients were segregated according is age, sex, number of grafts performed, or graft conduit (internal mammary artery versus vein) were not significant. However, comparison of graft conduits revealed a significantly better (p = 0.02) overall acute event-free survival when the internal mammary artery was used.




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