Article

Survival following myocardial revascularization

Author and Disclosure Information

Abstract

Since direct revascularization surgery was first begun at St. Luke’s Hospital, we have closely followed our patients through ongoing research projects or yearly questionnaires or both. A high degree of follow-up has been maintained yearly (97.5% to June 1976). This review includes 4603 patients who had direct revascularization surgery at St. Luke’s Hospital from 1968 through June 1, 1976.

These 4603 patients had an operative mortality of 4% (Fig. 1). At 4 years, there was 88% survival, and at 8 years, 75% survival which is 3.06% annual attrition rate. The term annual attrition rate is used to describe average annual death rate, and will in all cases include operative mortality.

A total of 1256 patients who had revascularization from 1968–1971 had an average operative mortality of 9%. This includes operative mortality of 16% in 1968 and 19.5% in 1969, with subsequent yearly improvement to the present time. At 8 years, 69.5% survived, resulting in a 3.83% annual attrition rate.

A great deal of difference is noted in the experience of the last 4 years, in which 3347 patients had revascularization operation, with an average 2.1% operative mortality and an annual attrition rate of 2% (90% survival at 5 years).

The long-term differences are not explained by the gross differences in operative mortality (Fig. 2). Even excluding the operative mortality, our earlier group had a 2.67% annual mortality compared to 1.6% annual mortality of our more recent group (p > 0.001). In addition to better operative skills, pump perfusion, anesthesia . . .


 

References