Ninet J, Cochet P, Rizk M, Neidecker J, Champsaur G
Service de chirurgie thoracique et cardio-vasculaire, Hôpital cardio-vasculaire et pneumologique Louis-Pradel, Lyon.
Arch Mal Coeur Vaiss. 1989 Jan;82(1):57-62.
Among the 628 consecutive patients who underwent coronary bypasses performed by the same surgical group between January 1, 1982 and December 31, 1987, 71 (11 p. 100) were aged 70 years or more (mean: 72.5 years; range: 70-83 years). 99 p. 100 of the patients had a history of severe, disabling exertional angina (46 p. 100) or unstable angina (52 p. 100) of 55 months' duration on average; 35 patients (49 p. 100) had already experienced myocardial infarction. Coronary angiography showed a one-vessel disease in 1 case, a two-vessel disease in 1 case, a two-vessel disease in 31 cases and a three-vessel disease in 39 cases; 11 patients (15 p. 100) had stenosis of the left main coronary artery. The ventricular function was considered unaltered in 59 cases (83 p. 100). Altogether, 155 bypasses, including 25 internal mammary grafts, were performed, i.e. an average of 2.2 bypasses per patient. There was only one early (21st day) post-operative death. The post-operative period was uneventful in 57 patients (60 p. 100); 9 developed peri-operative necrosis. Seventy patients have been followed up for a mean period of 24 months: there were 3 late deaths of non-cardiac origin; 60 patients (84.5 p. 100) are now asymptomatic and 3 (4.5 p. 100) are suffering from residual angina. Early mortality excluded, the cumulative probability of survival at 5 years is 94 p. 100.(ABSTRACT TRUNCATED AT 250 WORDS)
在1982年1月1日至1987年12月31日期间由同一手术团队连续进行冠状动脉搭桥手术的628例患者中，71例（11%）年龄在70岁及以上（平均72.5岁；范围70 - 83岁）。99%的患者有严重的、致残性劳力性心绞痛病史（46%）或平均病程55个月的不稳定型心绞痛病史（52%）；35例患者（49%）曾发生过心肌梗死。冠状动脉造影显示单支血管病变1例，双支血管病变1例，双支血管病变31例，三支血管病变39例；11例患者（15%）有左主干冠状动脉狭窄。59例患者（83%）的心室功能被认为未改变。总共进行了155次搭桥手术，包括25次胸廓内动脉移植，即平均每位患者2.2次搭桥。术后仅1例早期（第21天）死亡。57例患者（60%）术后恢复顺利；9例发生围手术期坏死。70例患者平均随访24个月：有3例非心脏原因的晚期死亡；60例患者（84.5%）目前无症状，3例（4.5%）仍有残余心绞痛。排除早期死亡率后，5年累积生存率为94%。（摘要截选至250字）
