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During an 8 year interval, 184 patients with symptomatic single-vessel disease underwent coronary artery bypass grafting (CABG). There were no operative deaths and only one late cardiac death (5 year cumulative survival 97.9%). At 48 months mean follow-up, 91% are angina free or improved. The low incidence of perioperative and late myocardial infarction (MI) and the preservation of ventricular function seen on follow-up catheterization suggest that coronary bypass operations yield significant benefits in severely symptomatic patients with single-vessel disease. Evidence is presented which supports the idea that single-vessel coronary artery disease may be a unique manifestation of coronary atherosclerosis and not one stage in a continuum.

From January 1972 through December 1974, at Saint Louis University Medical Center (SLU), 345 patients similar to those of the VA Cooperative Coronary Artery Study received CABG. Operative mortality was SLU 2.3%, VA 5.6% (p < 0.05). Perioperative myocardial infarction rate was SLU 8.4%, VA 18% (p < 0.005). One year graft patency was SLU 87%, VA 71%; all grafts patent SLU 76%, VA 54%; at least one graft patent SLU 96%, VA 89%. SLU angina pectoris relief at five years was 90%. SLU patients free of myocardial infarction five years postoperatively was 83%. Comparative cumulative four year survivals were: [Table: see text] Cumulative four-year survival in 272 SLU patients (79%) completely revascularized was 94%, compared to SLU entire group of 95%, VA medical 86% (p < 0.002) and VA surgical 85% (p < 0.002). Comparing 1972-74 SLU results to VA medical and surgical groups, CABG prolonged life in patients with double and triple vessel disease and in those completely revascularized.