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European Heart Journal 1998 19(3):447-457; doi:10.1053/euhj.1997.0775
Copyright © 1998 by the European Society of Cardiology.
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Long-term clinical outcome following coronary artery bypass grafting for isolated stenosis of the left anterior descending coronary artery

HennessyT.G a, M.B Coddb, S Donnellya, C Hartigana, H.A McCanna, C McCarthya, M Neliganc, A.E Woodc, D Lukec, E McGovernc, T Aherned and D.D Sugrueaf1

a Department of Clinical Cardiology, Dublin, Ireland
b Departments of Epidemiology/Health Services Research, Mater Misericordiae Hospital (University College), Dublin, Ireland
c Department of Cardiothoracic Surgery, Mater Misericordiae Hospital (University College), Dublin, Ireland
d Department of Cardiothoracic Surgery, Cork Regional Hospital, Cork, Ireland

accepted September 5, 1997

Aims

To detail the clinical and angiographic profile, and long-term outcome in consecutive patients with isolated stenosis of the left anterior descending coronary artery undergoing bypass surgery.

Methods

A retrospective study of all patients (n=301) (January 1984–December 1990) and undergoing coronary artery bypass grafting for isolated left anterior descending disease, in the Irish Republic, was performed. Survival was compared with that of an exact age- and gender-matched cohort.

Results

Mean age was 53 (±9·3) years. There were 238 (79%) males. In 241 (80%) patients an internal thoracic arterial bypass graft was used. Operative mortality was 1·3%. Of the 280 (93%) patients alive (16 cardiac deaths) at 7·1 (±1·9) years, 105 (35%) had angina, 26 (9%) suffered an interval myocardial infarction, and repeat revascularization was required on 29 (10%). Female gender (P=0·002), pre-operative myocardial infarction (P=0·02), significant diagonal disease (P=0·04) and postoperative myocardial infarction (P=0·0001) were independently associated with survival. Females were more likely to develop congestive cardiac failure (P=0·01) or postoperative angina (P=0·03) than their male counterparts.

Conclusions

Survivorship (97%) and event-free survival (96%) at 5 years following coronary artery bypass grafting for isolated left anterior descending coronary artery disease is excellent and equivalent to an age-matched and gender-matched cohort.

Key Words: Bypass • grafting • coronary disease • survival

f1 Correspondence: Dr Declan Sugrue, Dept of Clinical Cardiology, Mater Misericordiae Hospital (University College), Eccles Street, Dublin 7, Ireland.


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