Key result
Myocardial revascularization for acute and chronic coronary heart disease has an overall operative mortality rate of 7%, and 3% in uncomplicated symptomatic cases.
Myocardial revascularization is indicated for proximal coronary lesions with severe angina, carrying an overall operative mortality of 7% and improving ventricular function when successful.
Mortality estimates inform procedural risk discussions; leaves open need for updated validation in contemporary practice.
Myocardial revascularization is ideally indicated for critical obstructive lesions in the proximal portions of the coronary vessel, particularly in the left coronary system, with minimally involved distal vessels. Two conditions indicate a serious deficiency in coronary blood supply: severe, disabling, intractable angina pectoris and unstable angina pectoris. The overall operative mortality rate is 7%, including patients with complications of myocardial ischemia (infarction, ventricular aneurysm); in "uncomplicated" symptomatic cases a rate of 3% should be attained. After successful revascularization of the myocardium, with a functioning vein graft and no postoperative myocardial damage, we have shown improved ventricular function. Patients with enlarged hearts with little or no angina, patients with distal as opposed to proximal obstructive disease, and patients with diffuse or localized myocardial scarring are not accepted for surgery.
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H.J.C. Swan (1973) conducted a review in Acute and Chronic Coronary Heart Disease. Myocardial revascularization was evaluated on Operative mortality rate. Myocardial revascularization for acute and chronic coronary heart disease has an overall operative mortality rate of 7%, and 3% in uncomplicated symptomatic cases.
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