RESUMO
Two hundred and thirteen patients underwent surgical treatment for coronary artery disease from 1968, May to 1983, Feb. at our Department. Clinical diagnosis was stable angina in 55 patients, unstable angina in 47, angina with complication in 9, myocardial infarction in 54, and post-infarction complication in 48. Two hundred consecutive postoperative patients were evaluated. There were 11 late deaths occurred including 4 cardiac deaths in origin. Causes of late cardiac deaths were sudden death in 2 patients and cardiac decompensation in 2 patients. Reinfarction was seen in 1 out of 2 sudden deaths. This case underwent only left ventricular aneurysmectomy without A-C bypass grafting. Preoperatively, 49.2% of the patients were in NYHA 2, 34.8% in NYHA 3, and 15.9% in NYHA 4, but postoperatively 86.3% in NYHA 1 and 13.7% in NYHA 2. Reoperative surgical indications were native coronary progression in 1 patient, graft obstruction in 1, and ascending aortic aneurysm in 1. Surgical treatment of coronary arterial disease has still many problems to be solved, especially in patient with cardiogenic shock, multi-vessel disease, cerebral vascular disease, abdominal aortic aneurysm and patient of old age. But, we believe the surgical treatment will make much progress with development of myocardial preservation, assisted circulation, membrane oxygenator and simultaneous operative techniques including complete revascularization.
