RESUMEN
A total of 187 patients underwent isolated aorto-left anterior descending artery (LAD) bypass grafting with the internal saphenous vein (ISV) (= 65) and left internal mammary artery (IM) (n = 122). The respective indications of the two techniques were not systematized: the comparison of the main preoperative data of the two groups showed a statistically higher number of risk factors (p less than 0,01), more multivessel coronary lesions (p less than 0,02) and more patients with dyskinetic left ventricles (p less than 0,05) in the ISV bypass group. There were no statistical differences between the two groups in early postoperative mortality (IM: 0,8 p. 100, ISV: 1,5 p. 100), early postoperative infarction (IM: 2,5 p. 100, ISV: 1,5 p. 100), or late postoperative infarction (IM: 3,8 p. 100, ISV: 2,6 p. 100). The survival rates in the two groups were very similar with a global 90 p. 100 survival at 5 years and 78 p. 100 at 9 years. A comparison of the functional result in the two groups did not reveal significant difference: globally, 56 p. 100 of patients had no recurrence of angina 5 years, and 41 p. 100 after 9 years. Age, sex previous infarction, the number of cardiovascular risk factors, the technique used, had no prognostic significance on survival or on the quality of the postoperative functional results, contrary to the quality of left ventriculography and the number of coronary stenoses (83 subjects with isolated LAD disease, 104 subjects with multiple vessel disease). Nevertheless, patients with multiple coronary lesions had their vital prognosis improved (annual mortality less than 3 p. 100) compared to the spontaneous risk by isolated isolated aorto-LAD artery bypass surgery.