Survival following myocardial revascularization

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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 . . .