Long-term clinical outcome following coronary artery bypass grafting for isolated stenosis of the left anterior descending coronary artery

Aims To detail the clinical and angiographic profile, and long-termoutcome in consecutive patients with isolated stenosis of theleft anterior descending coronary artery undergoing bypass surgery. Methods A retrospective study of all patients (n=301) (January 1984–December1990) and undergoing coronary artery bypass grafting for isolatedleft anterior descending disease, in the Irish Republic, wasperformed. Survival was compared with that of an exact age-and gender-matched cohort. Results Mean age was 53 (±9·3) years. There were 238 (79%)males. In 241 (80%) patients an internal thoracic arterial bypassgraft was used. Operative mortality was 1·3%. Of the280 (93%) patients alive (16 cardiac deaths) at 7·1 (±1·9)years, 105 (35%) had angina, 26 (9%) suffered an interval myocardialinfarction, and repeat revascularization was required on 29(10%). Female gender (P=0·002), pre-operative myocardialinfarction (P=0·02), significant diagonal disease (P=0·04)and postoperative myocardial infarction (P=0·0001) wereindependently associated with survival. Females were more likelyto develop congestive cardiac failure (P=0·01) or postoperativeangina (P=0·03) than their male counterparts. Conclusions Survivorship (97%) and event-free survival (96%) at 5 yearsfollowing coronary artery bypass grafting for isolated leftanterior descending coronary artery disease is excellent andequivalent to an age-matched and gender-matched cohort.