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- Brandrup-Wognsen, G, et al.
(författare)
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Predictors for recurrent chest pain and relationship to myocardial ischaemia during long-term follow-up after coronary artery bypass grafting
- 1997
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Ingår i: European Journal of Cardio-Thoracic Surgery. - : Elsevier BV. - 1010-7940 .- 1873-734X. ; 12:2, s. 304-311
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To describe the impact of coronary artery bypass grafting on chest pain during 2 years of follow-up after the operation and to identify predictors of chest pain and its relationship to myocardial ischaemia 2 years after the operation. Methods: Patients were approached with a questionnaire at the time of coronary angiography (1291) and 3 months (1664), 1 year (1638) and 2 years (1613) after coronary artery bypass grafting. Two years after the operation, a computerised 12-lead electrocardiogram was obtained during a standardised bicycle exercise test (618). Results: Prior to surgery, 37% of the patients were unable to perform physical activity compared with 6% after the operation (PB0.0001 for change in degree of limitation). Only 3% had no chest pain at all prior to the operation, while 58% of the patients were free from chest pain 2 years after surgery (PB0.0001). We found no correlation between patients reporting chest pain and signs of ischaemia at exercise test, but there was a highly significant correlation with chest pain during the exercise test (PB0.0001). Independent predictors of chest pain were severity of preoperative angina (PB0.0001), younger age (P 0.0009), previous coronary artery bypass grafting (P 0.003), duration of symptoms (P 0.005), the need for prolonged cardiopulmonary bypass (P 0.04) and the absence of left main stenosis (P 0.04). Conclusion: Independent predictors of chest pain were identified 2 years after coronary artery bypass grafting. There was a dramatic improvement after coronary artery bypass grafting. However, almost half the patients complained of some kind of chest pain even after the operation. This chest pain correlated well with chest pain during the exercise test but not with signs of myocardial ischaemia.
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| 2. |
- Herlitz, Johan, et al.
(författare)
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Mortality and morbidity among patients who undergo combined valve and coronary artery bypass surgery. Early and late results
- 1998
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Ingår i: European Journal of Cardio-Thoracic Surgery. - : Elsevier BV. - 1010-7940 .- 1873-734X. ; 12:6, s. 836-846
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To describe mortality and morbidity early and late after combined valve surgery and coronary artery bypass grafting (CABG) as compared with CABG alone. PATIENTS and METHODS: All patients from western Sweden in whom CABG in combination with valve surgery or CABG alone was carried out in 1988-1991. RESULTS: Among 2116 patients who underwent CABG, 35 (2%) had this combined with mitral valve surgery and 134 (6%) had this combined with aortic valve surgery, whereas the remaining 92% underwent CABG alone. Patients who underwent combined valve surgery and CABG were older, included more women and had a higher prevalence of previous congestive heart failure and renal dysfunction but on the other hand a less severe coronary artery disease. Among patients who underwent mitral valve surgery in combination with CABG the mortality over the subsequent 5 years was 45%). The corresponding figure for patients who underwent aortic valve surgery in combination with CABG was 24%. Both were higher than for CABG alone (14%; P < 0.0001 and P = 0.003, respectively). In a stepwise multiple regression model mitral valve surgery in combination with CABG was found to be an independent significant predictor for death but aortic valve surgery in combination with CABG was not. Among patients who underwent mitral valve surgery in combination with CABG and were discharged alive from hospital 77% were rehospitalized during the 2 years following the operation as compared with 48% among patients who underwent aortic valve surgery in combination with CABG and 43% among patients with CABG alone. Multiple regression identified mitral valve surgery in combination with CABG as a significant independent predictor for rehospitalization but not aortic valve plus CABG. CONCLUSION: Among patients who either underwent CABG in combination with mitral valve surgery or aortic valve surgery or CABG alone, mitral valve surgery in combination with CABG was independently associated with death and rehospitalization, but the combination of aortic valve surgery and CABG was not.
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