This Article Order Full text via Infotrieve Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Campeau, L. Articles by Bourassa, M. G. Search for Related Content PubMed PubMed Citation Articles by Campeau, L. Articles by Bourassa, M. G.

Circulation, Vol 60, 1-5, Copyright © 1979 by American Heart Association

ARTICLES

Loss of the improvement of angina between 1 and 7 years after aortocoronary bypass surgery: correlations with changes in vein grafts and in coronary arteries

L Campeau, J Lesperance, J Hermann, F Corbara, CM Grondin and MG Bourassa

Improvement of effort angina following pure aortocoronary bypass graft surgery was related to postoperative control angiographic studies of grafts and coronary arteries in 75 unselected patients. Clinical and angiographic evaluations were carried out at approximately 1 year and at 5 to 7 years after surgery. At 1 year, 61 (81.3%) were improved (52 without angina and 9 with partial improvement by at least two functional classes), whereas 14 were unimproved (18.7%). At approximately 6 years, loss of improvement (reappearance of angina or aggravation by at least two functional classes) was observed in 22 of the 61 improved patients, representing an attrition of 36.1% over a 5- year period. Graft occlusion or a narrowing of over 50% was observed in two of the 39 patients in whom improvement had continued (5.1%), whereas it was found in six of the 22 patients (27.3%) whose results deteriorated (p less than 0.05). Similarly, progression to occlusion of a preexisting stenosis of over 50% or appearance of a new stenosis of over 50% in a major coronary artery (distal to a graft or in an unbypassed artery) was observed in five of the 39 patients with continued improvement (12.8%) and in 11 of the 22 patients whose condition deteriorated (p less than 0.01). Changes in a graft or in a coronary artery were noted in 63.6% (14/22) of the patients with loss of improvement as compared to only 18% (7/39) of the patients whose improvement did not deteriorate. Improvement of angina was also evaluated in all survivors among our first 500 cases who had preoperative effort angina and pure bypass surgery with or without angiographic studies. Of these 260 patients, 70.4% were angina-free or improved by two to three functional classes at 1 year, and only 41.9% at 7 years after surgery. It is concluded that the effect of aortocoronary bypass graft surgery is transient in a high proportion of patients and that deterioration of results is related to late graft modifications and progression of atherosclerosis, particularly in ungrafted coronary arteries.

This article has been cited by other articles:

				J. Garcia-Tejada, M. Velazquez, F. Hernandez, A. Albarran, S. Rodriguez, I. Gomez, J. Andreu, and J. Tascon Percutaneous Revascularization of Grafts Versus Native Coronary Arteries in Postcoronary Artery Bypass Graft Patients Angiology, February 1, 2009; 60(1): 60 - 66. [Abstract] [PDF]

				V. Mathew, S.H. Wilson, G.W. Barsness, R.L. Frye, R. Lennon, and D.R. Holmes Comparative outcomes of percutaneous coronary interventions in diabetics vs non-diabetics with prior coronary artery bypass grafting Eur. Heart J., September 2, 2002; 23(18): 1456 - 1464. [Abstract] [Full Text] [PDF]

				S. C. Smith Jr, J. T. Dove, A. K. Jacobs, J. Ward Kennedy, D. Kereiakes, M. J. Kern, R. E. Kuntz, J. J. Popma, H. V. Schaff, D. O. Williams, et al. ACC/AHA guidelines for percutaneous coronary intervention (revision of the 1993 PTCA guidelines): A report of the American College of Cardiology/ American Heart Association Task Force on practice guidelines (Committee to revise the 1993 guidelines for percutaneous transluminal coronary angioplasty) endorsed by the Society for Cardiac Angiography and Interventions J. Am. Coll. Cardiol., June 15, 2001; 37(8): 2239 - 2239. [Full Text] [PDF]

				K. A. Eagle, R. A. Guyton, R. Davidoff, G. A. Ewy, J. Fonger, T. J. Gardner, J. P. Gott, H. C. Herrmann, R. A. Marlow, W. C. Nugent, et al. ACC/AHA guidelines for coronary artery bypass graft surgery: A report of the American College of Cardiology/ American Heart Association task force on Practice Guidelines (Committee to revise the 1991 Guidelines for Coronary Artery Bypass Graft Surgery) J. Am. Coll. Cardiol., October 1, 1999; 34(4): 1262 - 1347. [Full Text] [PDF]

				M. Mosseri, D. Admon, Y. Hasin, M. Kriwitzki, S. Rosenheck, and M. S. Gotsman Percutaneous Angioplasty of Totally Occluded Coronary Vein Bypass Grafts: Case Histories Angiology, January 1, 1990; 41(1): 44 - 52. [Abstract] [PDF]

				J. Hassoulas and O. Ayzenberg Experimental Evaluation of the Mitroflow Pericardial Heart Valve Prosthesis. Part I. In Vivo Hemodynamic Evaluation Angiology, August 1, 1988; 39(8): 725 - 732. [Abstract] [PDF]

				J. Hassoulas and A.G. Rose Experimental Evaluation of the Mitroflow Pericardial Heart Valve Prosthesis. Part II. Pathologic Examination Angiology, August 1, 1988; 39(8): 733 - 741. [Abstract] [PDF]

				A. Kantrowitz Restoring Cardiac Function: An Emerging Spectrum of Therapeutic Options J Biomater Appl, January 1, 1986; 1(1): 13 - 38. [Abstract] [PDF]

				Cardiovascular Diseases: An Annotated Bibliography of Recent Literature: References to Journal Articles and Other Papers Ann Intern Med, May 1, 1983; 98(5_Part_1): 679 - 685. [Abstract] [PDF]