Does indirect revascularization using a combination of Beck and Vineberg procedures improve outcomes in patients with angina pectoris compared to the Beck procedure alone?
Indirect revascularization with combined Beck and Vineberg procedures provided subjective and objective improvement in angina but did not significantly outperform the Beck procedure alone.
A series of 61 patients was treated surgically for angina pectoris. Indirect revascularization was carried out by a combination of the Beck and Vineberg procedures. The first consecutive 56 patients were included in a follow-up examination about one year after operation. There was no operative mortality but there was a primary (hospital) mortality of 6.5 per cent (4 patients). Two of these patients died from myocardial failure, and the other 2 due to other reasons. There was an additional mortality of 8 per cent during the first postoperative year.To judge by the results of the graded exercise-tolerance test, 58 per cent of the re-examined cases were “objectively” improved, 23 per cent were unchanged and 19 per cent had deteriorated. From the subjective aspect (attacks of angina pectoris) the corresponding values were 77, 15 and 8 per cent. Angiography of the implanted internal mammary artery showed patency in 22 out of 48 examined patients (46 per cent). There was no general correlation between degree of patency of the internal mammary artery and “objective” or “subjective” improvement. In 11 cases with a highly stenotic or occluded anterior descending branch of the left coronary artery preoperatively, and a patent implanted artery after operation, there was a tendency to a more favourable result, although of modest magnitude, than in the remaining cases. The present series of patients was compared with a similar series operated on earlier by the Beck procedure. The results in the two series did not differ significantly.
Björk et al. (1968) studied this question.