Circulation, Vol 60, 14-16, Copyright © 1979 by American Heart Association
RL Thurer, BW Lytle, DM Cosgrove and FD Loop
A consecutive series of 17 patients surgically treated for asymptomatic
coronary artery disease was surveyed for survival, clinical status, and
graft patency after a mean follow-up of 75 months. Documented myocardial
infarction (MI), 14 transmural and 3 subendocardial, was the major
indication for catheterization. All patients were asymptomatic for at least
4 months prior to surgery. Six patients had greater than 70% obstruction in
one vessel, seven in two vessels, and four in three vessels. The indication
for revascularization was critical stenoses in vessels supplying large
areas of viable myocardium. All patients received left internal mammary
artery (LIMA) grafts to the left anterior descending coronary artery; seven
patients also received saphenous vein grafts (SVG) to other vessels. There
was no operative or late mortality. In 12 patients, postoperative
angiography (mean interval, 12 1/2 months) showed 11/12 LIMA and all SVG
patent. One incompletely revascularized patient with an occluded LIMA is
symptomatic. All others are fully active without symptoms or interval MI
after a minimum follow-up of 5 1/2 years. The safety and long-term results
of myocardial revascularization warrant its consideration for selected
asymptomatic postinfarction patients.
ARTICLES
Asymptomatic coronary artery disease managed by myocardial revascularization: results at 5 years
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