Veterans Administration cooperative study of surgery for coronary arterial occlusive disease: view from a noncooperating hospital

Circulation
J S CareyG F Groner

Abstract

Wadsworth Veterans Administration Hospital (VA-W) dropped out of the VA Coronary Cooperative Study (VA-Coop) in 1971 because of difficulty adhering to selection criteria, and because of the lack of standardization of surgical methods. Comparison of results from 1972-1974 showed the following differences: cardiopulmonary bypass time per graft, 61 minutes (VA-Coop) vs 33 minutes (VA-W); perioperative myocardial infarction (MI), 18% vs 6%; hospital mortality, 6% vs 1%; revascularization index (patent grafts per patient determined by postoperative angiography divided by diseased arteries per patient), 0.55 (VA-Coop) vs 0.84 (VA-W). However, the slopes of the actuarial survival curves were similar after the first year. In a group of patients operated on at UCLA and VA-W (UC-VA) during 1969-1971, the 1-year survival rate was 85%, but the annual death rate thereafter was also approximately 2% per year. The survival of VA-Coop surgical patients with three-vessel disease without left main lesions was significantly better (p less than 0.05 by Wilcoxon test) than the medical group with the 6-month (surgical) mortality adjusted to a more acceptable level (5%). These results indicate that coronary bypass surgery produces an annual mortality...Continue Reading

Citations

Jan 1, 1981·Scandinavian Journal of Thoracic and Cardiovascular Surgery·V O Björk, T Ivert

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