Coronary artery disease and coronary bypass grafting in young men: Experience with 138 subjects 39 years of age and younger

One hundred thirty-eight men aged ≤39 years had coronary bypass grafting during a 13 year period. Angina was the presenting symptom in 77% and of these patients, one-third had unstable angina. More than half of the patients had experienced at least one myocardial infarct. There was a high incidence...

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Bibliographic Details
Published in:	Journal of the American College of Cardiology Vol. 9; no. 5; pp. 977 - 988
Main Authors:	FitzGibbon, Gerald M., Hamilton, Mark G., Leach, Alan J., Kafka, Henryk P., Markle, Herbert V., Keon, Wilbert J.
Format:	Journal Article
Language:	English
Published:	New York, NY Elsevier Inc 01-05-1987 Elsevier Science
Subjects:	Adult Angiography Biological and medical sciences Cardiology. Vascular system Coronary Artery Bypass Coronary Disease - diagnostic imaging Coronary Disease - surgery Coronary heart disease Exercise Test Heart Heart Ventricles - diagnostic imaging Humans Male Medical Records Medical sciences Postoperative Complications Reoperation Risk Smoking Time Factors Human Aortocoronary Bypass Surgery Young adult Cardiovascular disease Coronary heart disease Survival
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Summary:	One hundred thirty-eight men aged ≤39 years had coronary bypass grafting during a 13 year period. Angina was the presenting symptom in 77% and of these patients, one-third had unstable angina. More than half of the patients had experienced at least one myocardial infarct. There was a high incidence of coronary risk factors, especially smoking. Nineteen patients (13.8%) had left main coronary artery stenosis (it was isolated in two); 13.8, 24.6 and 60.2% had single, double and triple vessel disease, respectively. Left ventriculograms showed serious functional impairment in 42%. A total of 461 coronary bypass grafts, 3.34 per patient, were placed; almost all were vein grafts. There were no operative deaths. Transmural myocardial infarction occurred in 4.3% of patients. All bypass grafts were opacified angiographically early after operation, 95% at 1 year, 56% at 5 years and 26% at 10 years after operation. Some patients also had coronary angiograms, dictated by clinical events, between 1 and 5 and between 5 and 10 years postoperatively. Patency rates for bypass grafts were comparable with those previously reported and were acceptable, although they decreased with time. However, increasing evidence of atherosclerosis of bypass grafts was seen beyond 1 year, particularly beyond 5 years. Of 23 subjects with a coronary bypass reoperation, 2 died and 44% had perioperative transmural myocardial infarction. During follow-up, 13.8% of the patients died, survival being 95, 84 and 76% at 5, 10 and 12 years, respectively. It is considered that the patients were advantageously treated with coronary bypass grafting especially in the short-term. However, bypass graft patency steadily decreased with the passage of time and graft atherosclerosis became an increasingly important problem.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0735-1097 1558-3597
DOI:	10.1016/S0735-1097(87)80297-8