Huttunen K, Rehnberg S, Huttunen H, Soimakallio S, Suhonen M, Helin M
Department of Thoracic Surgery, Kuopio University Central Hospital, Finland.
Scand J Thorac Cardiovasc Surg. 1989;23(1):19-23. doi: 10.3109/14017438909105961.
One hundred patients with high-risk unstable and medication-resistant angina pectoris underwent coronary artery by-pass grafting. In 35 cases the angina was of early post-infarction type, in 60 it was progressive after previous stability and in five it was of recent onset. All had abnormal ECG in association with anginal attacks (ST depression in 76, ST elevation in 5, T-wave inversion in 15 and left bundle branch block in 4). The left main coronary artery was stenosed in 33 patients, and the respective figures for three-vessel, two-vessel and one-vessel disease were 53, 9 and 5. The average number of inserted peripheral grafts/patient was 4.6. The perioperative mortality rate was 1%. Seven patients had confirmed or probable perioperative myocardial infarction and two had late infarction during the hospital stay, but none had angina pectoris on discharge. Of 60 patients re-examined after 1 year, 47 were angina-free. Five had NYHA class III angina, but all were improved. In refractory unstable angina pectoris there is severe coronary artery involvement, but bypass grafting can give good results.
100例高危不稳定型及药物抵抗型心绞痛患者接受了冠状动脉搭桥术。其中35例为心肌梗死后早期心绞痛，60例为先前病情稳定后病情进展型，5例为近期发作型。所有患者心绞痛发作时均伴有心电图异常（76例ST段压低，5例ST段抬高，15例T波倒置，4例左束支传导阻滞）。33例患者左主干冠状动脉狭窄，三支血管病变、两支血管病变和单支血管病变的患者分别为53例、9例和5例。每位患者平均植入外周移植物4.6个。围手术期死亡率为1%。7例患者确诊或可能发生围手术期心肌梗死，2例在住院期间发生晚期梗死，但出院时均无心绞痛。60例患者在1年后复查，47例无心绞痛。5例为纽约心脏病协会（NYHA）III级心绞痛，但均有改善。在难治性不稳定型心绞痛中，冠状动脉受累严重，但搭桥术可取得良好效果。
