Changes in coronary bypass surgery leading to improved survival
S. H. Rahimtoola, G. L. Grunkemeier, J. F. Teply, L. E. Lambert, D. R. Thomas, Y. F. Suen and A. Starr
Coronary bypass surgery was performed on 439 patients between the years
1969 and 1973 (group A) and on 1,760 patients between the years 1974 and
1979 (group B). The operative mortality for group A was 3.9%; for group B,
1.3%; four-year survival for group A patients was 88.9% +/- 1.5% (mean +/-
SE); for group B patients, 92.5% +/- 0.9%. The difference between the
relative four-year survival rates (based on age- and sex-matched Oregon
population) between group B and A was 6.2%; the lower operative mortality
would account for only 2.6%. We conclude that the results of coronary
bypass surgery have improved because of (1) a lower operative mortality,
and (2) other factors that cannot be precisely defined at the present time
but probably are the long-term result of better and more complete operative
and perioperative techniques.
