Coronary artery bypass graft outcome: the Trinidad and Tobago experience

The study is a retrospective review of the demographic, clinical, angiographic, and operative data of the first 205 consecutive CABG operations performed by Caribbean Heart Care at the Eric Williams Medical Sciences Complex (EWMSC), Trinidad and Tobago, between November 1993 and December 1997. The aim of the study was to determine the in hospital and intermediate term follow up results. The mean age of patients was 59 ñ 10 years and 78 percent male. Sixty-four percent were of East Indian descent, whereas, 16 percnt were of Africian descent. Forty-eight percent of the patients were hypertensive, 46 percent were diabetic, 33 percent had hyperlipidaemia, 20 percent had a recent history of cigarette smoking and 16 percent were obese. Sixty-five percent had a positive family history of ischaemic heart disease. The average time interval between angiography and surgery was 2.3 months. At the time of angiography, 63.5 percent of patients had Canadian Cardiac Society (CCS) class 3 or 4 angina. The mean ejection fraction was 61 ñ 15 percent. Wall motion abnormalities were seen in 67 pecent of patients. Significant stenoses of the left anterior descending artery, right circumflex artery, circumflex and ramus coronary arteries were present in 91 percent, 78 percent, 54 percent and 5 percent, respectively. Many patients (67 percent) had severe diffuse disease on angiography. The mean intensive care stay was 2.2 ñ 0.8 days. In hospital mortality was 3.9 percent (8/205). THe most frequent post operative complicaton was haemorrhage (2.6 percent). Acute renal failure occurred in 2.1 percent; pulmonary collapse, 1.6 percent; 1 percent and cardiac arrest , 1 percent. Both sternal wound infections and systemic sepsis occurred in 0.5 percent. Intermediate term follow-up data were obtained for 92 percent (189/205). The duration of follow-up ranged from 1 to 5 years (mean 3.7 years). During the follow up period, 7 patients (3.4 percent) died. Angina severity was reduced from a mean CCS score of 2.61 ñ 0.95 before CABG ot 1.22 ñ 0.55 at the time of follow up (p<0.0001). Overall 4-year mortality compared favourably with data from international studies. Among survivors, quality of life improved as evidenced by the reduction in the mean angina score.(Au)

Coronary artery bypass graft outcome: the Trinidad and Tobago experience

The study is retrospective review of the demographic, clinical, angiographic, and operative data of the first 205 consecutive CABG operations performed by Caribbean Heart Care at the Eric Williams Medical Sciences Complex (EWMSC), Trinidad and Tobago, between November 1993 and December 1997. The aim of the study was to determine the in-hospital and intermediate-term follow-up results. The mean age of patients was 59 +/- 10 years and 78 were male. Sixty-four per cent were of East Indian descent, whereas 16 were of African descent. Forty-eight per cent of the patients were hypertensive, 46 were diabetic, 33 had hyperlipidaemia, 20 had a recent history of cigarette smoking and 16 were obese. Sixty-five per cent had a positive family history of ischaemic heart disease. The average time interval between angiography and surgery was 2.3 months. At the time of angiography, 63.5 of patients had Canadian Cardiac Society (CCS) class 3 or 4 angina. The mean ejection fraction was 61 +/- 15. Wall motion abnormalities were seen in 67 of patients. Significant stenoses of the left anterior descending artery, right circumflex artery, circumflex and ramus coronary arteries were present in 91, 78, 54 and 5, respectively. Many patients (67) had severe diffuse disease on angiography. The mean intensive care stay was 2.2 +/- 0.8 days. In-hospital mortality was 3.9 (8/205). The most frequent post-operative complication was haemorrhage (2.6). Acute renal failure occurred in 2.1; pulmonary collapse, 1.6; stroke, 1 and cardiac arrest, 1. Both sternal wound infections and systemic sepsis occurred in 0.5. Intermediate-term follow-up data were obtained for 92 (189/205). The duration of follow-up ranged from 1 to 5 years (mean 3.7 years). During the follow-up period, 7 patients (3.4) died. Angina severity was reduced from a mean CCS score of 2.61 +/- 0.95 before CABG to 1.22 +/- 0.55 at the time of follow-up (p < 0.0001). Overall 4-year mortality compared favourably with data from international studies. Among survivors, quality of life improved as evidenced by the reduction in the mean angina score.

Coronary artery bypass surgery in Trinidad: morbidity and mortality - Poster abstract

OBJECTIVE: To determine whether Coronary artery bypass grafting (CABG) in Trinidad influenced morbidity and mortality. METHOD: Retrospective review of the demographic, clinical and angiographic data of the first 205 consecutive CABG operations performed by Caribbean Heart Care at the Eric Williams Medical Sciences Complex, Trinidad, between November 1993 and December 1997. RESULTS: The mean age was 59 ñ 10 years and 74 percent were males. The average time interval between angiography and surgery was 2.3 months. At the time of angiography, 69 percent of patients had class 3 or 4 angina (CCS). The mean ejection fraction was 63 ñ 13 percent. Many patients (64 percent) had severe diffuse disease on angiography. The in-hospital mortality was 8/205 (3.9 percent). Follow-up data were obtained for 189/205 (92 percent). The duration of follow-up ranged from 1 to 5 years. During the follow-up period, 7/189 patients. (3.4 percent) died. Angina severity before and after surgery was determined in 174 surviving patients. Angina severity was reduced from a mean CCS score of 2.61 ñ 0.95 before CABG to 1.22 ñ 0.55 after CABG (p<0.0001). CONCLUSION: Overal 4-year mortality compared favourably with data from international studies. Amongst survivors, quality of life improved as evidenced by the reduction in the mean angina score.(AU)

Coronary artery bypass graft outcome: the Trinidad and Tobago experience.

The study is retrospective review of the demographic, clinical, angiographic, and operative data of the first 205 consecutive CABG operations performed by Caribbean Heart Care at the Eric Williams Medical Sciences Complex (EWMSC), Trinidad and Tobago, between November 1993 and December 1997. The aim of the study was to determine the in-hospital and intermediate-term follow-up results. The mean age of patients was 59 +/- 10 years and 78% were male. Sixty-four per cent were of East Indian descent, whereas 16% were of African descent. Forty-eight per cent of the patients were hypertensive, 46% were diabetic, 33% had hyperlipidaemia, 20% had a recent history of cigarette smoking and 16% were obese. Sixty-five per cent had a positive family history of ischaemic heart disease. The average time interval between angiography and surgery was 2.3 months. At the time of angiography, 63.5% of patients had Canadian Cardiac Society (CCS) class 3 or 4 angina. The mean ejection fraction was 61 +/- 15%. Wall motion abnormalities were seen in 67% of patients. Significant stenoses of the left anterior descending artery, right circumflex artery, circumflex and ramus coronary arteries were present in 91%, 78%, 54% and 5%, respectively. Many patients (67%) had severe diffuse disease on angiography. The mean intensive care stay was 2.2 +/- 0.8 days. In-hospital mortality was 3.9% (8/205). The most frequent post-operative complication was haemorrhage (2.6%). Acute renal failure occurred in 2.1%; pulmonary collapse, 1.6%; stroke, 1% and cardiac arrest, 1%. Both sternal wound infections and systemic sepsis occurred in 0.5%. Intermediate-term follow-up data were obtained for 92% (189/205). The duration of follow-up ranged from 1 to 5 years (mean 3.7 years). During the follow-up period, 7 patients (3.4%) died. Angina severity was reduced from a mean CCS score of 2.61 +/- 0.95 before CABG to 1.22 +/- 0.55 at the time of follow-up (p < 0.0001). Overall 4-year mortality compared favourably with data from international studies. Among survivors, quality of life improved as evidenced by the reduction in the mean angina score.

Coronary artery bypass surgery at the Eric Williams Medical Sciences Complex: clinical profile and outcome - abstract

Coronary artery bypass grafting surgery (CABG) has been recently performed at the Eric Williams Medical Sciences Complex, for the management of patients with coronary artery disease (CAD). This is a review of the joint experience of the Eric WIlliams Medical Sciences Complex/Caribbean Heart Care Venture. Forty-one patients had CABG between November, 1993 and October, 1994. Their ages ranged from 39 to 73 years with mean age 56 years; 28 patients (83 per cent) were male and 7 (17 per cent) were female. Twenty patients (49 per cent) were hypertensive, 16 (39 per cent) were diabetic, 5 had mild pre-operative impairment of renal function, 1 had had previous bypass surgery in 1984 and pre-operatively most patients were using maximal oral therapy for angina control. The indications for surgery were: left main coronary disease (7 per cent), 3-vessel coronary disease with ejection fraction < 50 per cent (12 per cent), unstable or refractory stable angina due to 2-vessel, 3-vessel or proximal left anterior descending coronary disease with good LV function (80 per cent). Left internal mammary artery grafts were used in 68 per cent of patients and saphenous vein grafts in the rest. The mean stay in hospital post-operatively was 9.6 days. Two patients died, both in the early post-operative period. In two patients, in whom complete revascularization was not possible, mild angina occurred during the post-discharge mobilization period. All other patients have been free of angina since discharge. Complications included early re-operation (day 1) for excessive bleeding from the chest drains (1 patient), aortic dissection requiring repair (1 patient), lobar atelectasis requiring prolonged physiotherapy (4 patients), pneumonia (1 patient), severe transient post-pericardiotomy syndrome (1 patient) and peroneal nerve palsy (1 patient) (AU)