Surgery for ischaemic heart disease in the patient aged 40 and younger

A group of 128 patients with a mean age of 36 years, operated on between 1971 and 1986, were followed up over a period of up to 15 years. Their five-year survival was 90%, and 10-year survival 60%. The main cause of death was progression of ischaemic heart disease. The only factor affecting long-term survival is resection of a left ventricular aneurysm: patients who undergo this procedure exhibit a shorter survival (p less than 0.05). The number of vessels involved, performance of complete or incomplete revascularization, or ejection fraction data had no effect on patient survival. To improve the results of 10-year and longer follow-up, the patient must comply with the principles of secondary prevention of atherosclerosis, and the internal mammary artery should be used for reconstruction.