Coronary bypass surgery : what is changing? Analysis of 3834 patients undergoing primary isolated myocardial revascularization

• Published in: European journal of cardio-thoracic surgery Vol. 13; no. 4; pp. 365 - 369
• Main Authors: NOYEZ, L, JANSSEN, D. P. B, VAN DRUTEN, J. A. M, SKOTNICKI, S. H, LACQUET, L. K
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Science 01.04.1998
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Coronary Artery Bypass - trends; Female; Humans; Male; Medical sciences; Middle Aged; Postoperative Complications; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Human; Aortocoronary; Bypass; Surgery; Mortality; Evolution; Graft; Decision criterion; Morbidity
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1016/S1010-7940(98)00039-6

The patient population undergoing myocardial revascularization has changed during the last few years. Knowledge of these changes, and of the subsequent influence on morbidity and/or mortality is important, not only for up-dating quality control, but also to support decision-making in financial and economical aspects, and in further research concerning coronary artery surgery. Pre-, per- and postoperative data of 3834 primary isolated coronary bypass operations, January 1987 December 1995 were analyzed. The total group was divided into three time cohorts. Group A: 1987 1989 (n = 1292); group B: 1990-1992 (n = 1130); and group C: 1993-1995 (n = 1412). Mean age increased from 60.4 +/- 9.0 (S.D.) years in group A to 62.9 +/- 9.9 (S.D.) years in group C (P < 0.0005). Patients with insulin-dependent diabetic (P = 0.005), uro-nefrological (P = 0.002), pulmonary (P < 0.0005)and neurological (P = 0.003) pathology increased significantly, and there was a significant increase in the use of arterial grafts (P < 0.05). Postoperative, hospital mortality remained stable (+/- 2.5%). However, there was a significant increasing percentage of patients with pulmonary (P = 0.04), neurological (P = 0.02) and uro-nefrological (P < 0.0005) problems. During the last few years there has been a trend in myocardial revascularization of older patients, with more coexisting disease. Despite the fact that hospital mortality seems stable, there is an increase in major postoperative morbidity.