[主动脉冠状动脉搭桥术后的早期和晚期结果：500例经验]
[Early and late outcome after aortocoronary bypass: experience in 500 cases].
作者信息
Pelletier C, Cossette R, Dontigny L, Primeau R, Proulx J, Tremblay G
出版信息
Can Med Assoc J. 1979 Oct 20;121(8):1081-9.
Between 1971 and 1976, 500 patients underwent aortocoronary bypass surgery. There were 15 operative deaths (3%) and the total frequency of perioperative infarction was 7%. The operative mortality was 7.4% in unstable angina, as compared with 1.1% in stable angina (P less than 0.01). The proportion of grafts patent at 2 weeks was 92% and at 18 months 87.6%. Postoperative follow-up was complete for 99% of the patients. There were 15 late deaths (3%) and the rates of survival at 2 and 4 years were 94.4% and 92.1% respectively. The actuarial curve of survival after surgery was not significantly different from that of the general population. After a mean follow-up of 27 months 73% of the patients were completely free of angina and 19% were markedly improved. The rate of recurrence of angina averaged 10% per year and the annual infarction rate was 0.7%. Fourteen patients (3%) underwent reoperation during the follow-up period. Thus, coronary revascularization surgery offers effective and sustained relief of incapacitating angina and might also improve survival if the operative mortality is low.
1971年至1976年间，500例患者接受了主动脉冠状动脉搭桥手术。手术死亡15例（3%），围手术期梗死总发生率为7%。不稳定型心绞痛患者的手术死亡率为7.4%，而稳定型心绞痛患者为1.1%（P<0.01）。术后2周移植血管通畅率为92%，18个月时为87.6%。99%的患者完成了术后随访。晚期死亡15例（3%），2年和4年生存率分别为94.4%和92.1%。手术后的精算生存曲线与普通人群无显著差异。平均随访27个月后，73%的患者完全无心绞痛，19%的患者明显改善。心绞痛复发率平均每年10%，年梗死率为0.7%。14例患者（3%）在随访期间接受了再次手术。因此，如果手术死亡率较低，冠状动脉血运重建手术可有效且持续缓解致残性心绞痛，还可能改善生存率。
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