Early mortality after 2 902 coronary artery bypass operations

A review of 2,902 coronary artery bypass grafting operations is presented. During the 16-year study period the mean patient age rose from 51 to 59 years and the average number of grafts per patient from 1.5 to 3.0. There were 81 early deaths (2.8%, the most common cause being myocardial infarction (68%). Left main stem stenosis was present in 23 of these 81 patients and depressed left ventricular function in 30. Compared with the survivors, the deceased patients were characterized by higher age, proportionately large numbers of women, combined procedures and reoperations and less use of internal mammary artery grafts. Of the 94 patients aged greater than or equal to 70, 11 died (12%). The perioperative mortality was significantly greater (p less than 0.05) in women than in men (20/457 vs. 61/2445 viz. 4.4% vs. 2.5%). Combined operations were associated with 8.7% (27/311), reoperations with 6% (6/101) and coronary endarterectomy with 5% (4/75) early deaths. In the last year of the study there were three early deaths among 359 patients (0.8%) who underwent primary isolated coronary bypass grafting without endarterectomy. The perioperative risks fell steadily during 16 years, despite rising proportions of older patients, combined procedures, reoperation and coronary endarterectomy.