Laird-Meeter K, van Domburg R, van den Brand M J, Lubsen J, Bos E, Hugenholtz P G
Br Heart J. 1987 May;57(5):427-35. doi: 10.1136/hrt.57.5.427.
Reintervention was required in 123 (12%) individuals during a follow up (mean 7.5 years, range 5-14.5) of 1041 patients with consecutive, isolated, first aortocoronary bypass operations. In 89 patients the intervention was a repeat bypass operation, in 24 it was angioplasty, and 10 had both. Procedure related mortality was significantly higher at reintervention (5.6%) than at the primary operation (1.2%). Survival probability after a single bypass procedure was 90% at six years and 82(3)% at nine years. Corresponding figures six and nine years after reintervention were 89(6)% and 87(7)% respectively. Stepwise multivariate analysis showed that survival was significantly correlated with left ventricular function (rate ratio 1.82) and with extent of vascular disease (rate ratio 1.80) but not with reintervention (rate ratio 1.45). Symptomatic improvement occurred in 89% of the survivors with or without reintervention. Repeat procedures are often necessary after coronary artery bypass grafting but they appear to provide appreciable relief of symptoms without reducing any long term improvement in survival brought about by the original operation.
在对1041例接受连续、孤立的首次主动脉冠状动脉搭桥手术的患者进行随访（平均7.5年，范围5 - 14.5年）期间，123例（12%）患者需要再次干预。89例患者的干预措施是再次搭桥手术，24例是血管成形术，10例两者都做了。再次干预时与手术相关的死亡率（5.6%）显著高于初次手术时（1.2%）。单次搭桥手术后六年的生存概率为90%，九年时为82（3）%。再次干预后六年和九年的相应数字分别为89（6）%和87（7）%。逐步多变量分析表明，生存与左心室功能（率比1.82）和血管疾病程度（率比1.80）显著相关，但与再次干预无关（率比1.45）。无论是否进行再次干预，89%的幸存者症状都有改善。冠状动脉搭桥术后通常需要重复手术，但它们似乎能明显缓解症状，而不会降低初次手术带来的长期生存改善。
