Coronary artery bypass surgery at the Eric Williams Medical Sciences Complex: clinical profile and outcome - abstract

ABSTRACT

Coronary artery bypass grafting surgery (CABG) has been recently performed at the Eric Williams Medical Sciences Complex, for the management of patients with coronary artery disease (CAD). This is a review of the joint experience of the Eric WIlliams Medical Sciences Complex/Caribbean Heart Care Venture. Forty-one patients had CABG between November, 1993 and October, 1994. Their ages ranged from 39 to 73 years with mean age 56 years; 28 patients (83 per cent) were male and 7 (17 per cent) were female. Twenty patients (49 per cent) were hypertensive, 16 (39 per cent) were diabetic, 5 had mild pre-operative impairment of renal function, 1 had had previous bypass surgery in 1984 and pre-operatively most patients were using maximal oral therapy for angina control. The indications for surgery were left main coronary disease (7 per cent), 3-vessel coronary disease with ejection fraction < 50 per cent (12 per cent), unstable or refractory stable angina due to 2-vessel, 3-vessel or proximal left anterior descending coronary disease with good LV function (80 per cent). Left internal mammary artery grafts were used in 68 per cent of patients and saphenous vein grafts in the rest. The mean stay in hospital post-operatively was 9.6 days. Two patients died, both in the early post-operative period. In two patients, in whom complete revascularization was not possible, mild angina occurred during the post-discharge mobilization period. All other patients have been free of angina since discharge. Complications included early re-operation (day 1) for excessive bleeding from the chest drains (1 patient), aortic dissection requiring repair (1 patient), lobar atelectasis requiring prolonged physiotherapy (4 patients), pneumonia (1 patient), severe transient post-pericardiotomy syndrome (1 patient) and peroneal nerve palsy (1 patient) (AU)