[Aorto-coronary bypass. On 200 cases surgically treated (author's transl].

200 patients underwent bypass graft for treatment of severe coronary vessel disease. The bypass vein grafts were 316; single grafts in 100 cases, double in 85, triple in 14 and in 1 case a patient received 4 grafts. In 57 cases a previous coronary endarterectomy was performed. The flow in the graft at the end of the operation was more than 40 cc/min. in 80% of cases. 22 patients died. Postoperative myocardial infarction occurred in 14% of the patients. The mortality was higher in the preinfarction angina group, and less in the chronic angina group without concomitant surgery (7,2%) and is statistically in direct relation to the functional condition of the left ventricle (2,8% in patients with end diastolic left ventricular pressure less than 20 mmHg and without akinetic areas). Relief of angina was observed in 87% of the surviving patients. Postoperative coronarography, catheterism and left ventriculography was performed in 46 patients. Only 2 of the 15 cases with postoperative angina had the graft patent. Significant improvement of the left ventricular function with disappearence or regression of akinetic areas was observed in 9 patients. Our experience indicates that the value of this operation cannot be entirely known at the present time.