What are the operative mortality and postoperative myocardial infarction rates of elective aortocoronary saphenous vein graft surgery in a community hospital setting?
Elective saphenous vein graft surgery in a community hospital setting without academic affiliation had an overall operative mortality of 6.2%, which was heavily influenced by baseline left ventricular function and associated procedures.
In a community hospital setting, without academic affiliation or house staff coverage, 145 patients had elective saphenous vein graft surgery between January 1970 and January 1973. Patients with good left ventricular function, with or without associated procedures, had an operative mortality of 2.4%. The surgical mortality of patients who had associated procedures was 9.5%. The overall operative mortality was 6.2% with an immediate postoperative myocardial infarction rate of 17%. Results in 38 patients with pre-infarction angina were no different from the group as a whole. The risk of surgery is best categorized by a combination of angiographic severity of coronary artery disease plus severity of left ventricular dysfunction estimated by left ventriculogram.
Forker et al. (1974) studied this question.