Document Detail


Late results of coronary bypass in patients presenting with lower extremity ischemia: the Cleveland Clinic Study.
MedLine Citation:
PMID:  3509768     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cardiac catheterization was performed in a prospective series of 1000 patients under consideration for elective peripheral vascular reconstruction from 1978-1982. Of these, 381 (mean age 62) presented primarily because of lower extremity ischemia. Severe, surgically correctable coronary artery disease (CAD) was documented in 79 (21%) of the leg group, and 68 (18%) received myocardial revascularization, with three fatal complications (4.4%). In this subset, 39 patients have had uneventful aortoiliac, femoropopliteal or distal extremity procedures, compared to an operative mortality of 23% for 13 others with uncorrected or inoperable CAD (p = 0.015). A total of 286 patients have undergone 407 peripheral vascular operations with eight early deaths (2.8%). An additional 114 patients (30%) died during the late follow-up interval, including 48 (13%) with cardiac events. Both the cumulative 5-year survival (72%) and cardiac mortality (16%) after coronary bypass are superior to comparable figures (21% and 56%, respectively) among 36 other patients with severe, uncorrected or inoperable CAD (p = 0.0001). Five-year survival appears to be improved by myocardial revascularization in men (p = 0.0027), hypertensives (p = 0.0001), nondiabetics (p = 0.0002) and those over 60 years of age (p = 0.0072).
Authors:
N R Hertzer; J R Young; E G Beven; P J O'Hara; R A Graor; W F Ruschhaupt; L C Maljovec
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of vascular surgery     Volume:  1     ISSN:  0890-5096     ISO Abbreviation:  Ann Vasc Surg     Publication Date:  1987 May 
Date Detail:
Created Date:  1989-01-26     Completed Date:  1989-01-26     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8703941     Medline TA:  Ann Vasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  411-9     Citation Subset:  IM    
Affiliation:
Cleveland Clinic Foundation, Department of Vascular Surgery, Ohio 44106.
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MeSH Terms
Descriptor/Qualifier:
Actuarial Analysis
Adult
Age Factors
Aged
Aged, 80 and over
Anastomosis, Surgical / mortality
Coronary Artery Bypass / mortality*
Coronary Disease / complications,  surgery*
Diabetes Complications
Female
Follow-Up Studies
Humans
Hypertension / complications
Ischemia / complications*,  surgery
Leg / blood supply*,  surgery
Male
Middle Aged

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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