Killen D A, Wathanacharoen S, Reed W A, Piehler J M, Borkon A M, Gorton M E, Meuhlebach G F
MidAmerica Heart Institute, Saint Luke's Hospital, Kansas City, Missouri, USA.
Tex Heart Inst J. 1998;25(3):181-4.
We studied a series of 648 consecutive patients who underwent coronary artery bypass grafting for isolated primary disease of the anterior descending coronary artery. We evaluated the patients periodically during a long-term follow-up period of up to 17 years. We studied factors such as survival, survival without acute event (i.e., acute myocardial infarction, repeat coronary artery bypass, and percutaneous transluminal coronary angioplasty), and asymptomatic survival (i.e., survival without acute event or angina). We further analyzed these factors as they occurred in patients who received only saphenous vein grafts versus their occurrence in patients who received internal mammary artery grafts. There was 1 death in the early postoperative period (defined as 30 days or earlier after the operation). The 5-, 10-, and 15-year survival rates were 94.8%, 86.6%, and 72.2%, respectively. These survival rates are slightly better than those of an age- and sex-matched United States census population. In our series, the rates of survival, event-free survival, and asymptomatic survival were better, although not significantly so, in the group of 108 patients in whom the internal mammary artery was used as the bypass conduit. We conclude that patients who undergo coronary artery bypass grafting for isolated disease of the left anterior descending coronary artery enjoy normal survival rates, in comparison with the survival rates of an age- and sex-matched United States census population, through at least the 1st 16 postoperative years. Additionally, patients who receive an internal mammary artery bypass graft have slightly better rates of survival, event-free survival, and asymptomatic survival than do those who receive only saphenous vein grafts.
我们研究了一系列连续648例因单纯前降支冠状动脉原发性疾病而接受冠状动脉旁路移植术的患者。在长达17年的长期随访期间，我们定期对这些患者进行评估。我们研究了诸如生存率、无急性事件生存（即无急性心肌梗死、再次冠状动脉旁路移植术和经皮冠状动脉腔内血管成形术）以及无症状生存（即无急性事件或心绞痛生存）等因素。我们进一步分析了这些因素在仅接受大隐静脉移植的患者中的发生情况与接受乳内动脉移植的患者中的发生情况。术后早期（定义为术后30天或更早）有1例死亡。5年、10年和15年生存率分别为94.8%、86.6%和72.2%。这些生存率略高于年龄和性别匹配的美国人口普查人群。在我们的系列研究中，在108例使用乳内动脉作为旁路管道的患者组中，生存率、无事件生存率和无症状生存率更好，尽管差异不显著。我们得出结论，因单纯左前降支冠状动脉疾病接受冠状动脉旁路移植术的患者，与年龄和性别匹配的美国人口普查人群的生存率相比，至少在术后第16年享有正常生存率。此外，接受乳内动脉旁路移植的患者在生存率、无事件生存率和无症状生存率方面比仅接受大隐静脉移植的患者略好。
