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The Annals of Thoracic Surgery, Vol 28, 113-118, Copyright © 1979 by The Society of Thoracic Surgeons

ARTICLES

Prophylactic coronary artery grafting in patients with few or no symptoms

CM Grondin, JG Kretz, P Vouhe, JF Tubau, L Campeau and MG Bourassa

Fifty-five patients who underwent prophylactic coronary artery grafting were followed for 4 to 8 years. Sixteen patients had no angina, and 39 were in New York Heart Association Functional Class I. Twenty-one patients had single-vessel disease, 13 had double-vessel disease, and 27, triple-vessel disease. A total of 101 grafts were inserted. There were no operative deaths. Two patients suffered a perioperative myocardial infarction (MI), and 3 were reoperated on for persistent bleeding. Early after operation, 9 of the 45 grafts were occluded. At 1 year, 2 patients had occlusion of all grafts, and 1 had similar findings at 5 years. There were 4 late deaths, 3 related to coronary artery disease. Seven patients sustained a late MI. Thirty-one of the 51 survivors (60.8%) seen late (mean, 69.3 months) after operation were free from angina; 14 were in Class I and 6, Class II. It is apparent from this retrospective study that patients such as these stand to benefit little from prophylactic revascularization. Longevity may be increased, however, in patients who are asymptomatic after MI.