Coronary Artery Bypass Grafting (CABG): Reassessing Efficacy, Safety, and Cost

David K. Cundiff

In This Article

Operative Mortality of CABG

CABG operative deaths have remained in the range of about 3%, increasing, if anything, over the past 15 years because of the recent selection of older patients with more severe underlying disease.[34,35,36,37,38,39,40,41,42] Using American Heart Association CABG frequency and complication figures in the United States,[43] more than 185,000 operative deaths occurred from 1979 to 1998 (currently more than 15,000 per year). Add to this more than 16,000 deaths (currently about 1200 per year) from complications of 16 million coronary angiography procedures from 1979-1998,[43] each carrying a 0.1% to 0.2% mortality risk,[44,45] that were done to evaluate patients for CABG suitability.

Since the presumed efficacy of percutaneous transluminal coronary angioplasty (PTCA) depends largely on randomized comparisons with CABG,[46,47,48,49,50,51,52,53] CABG also accounts for a significant proportion of the approximately 39,000 deaths (currently about 5000 per year) that have resulted from 3.9 million PTCAs from 1986-1998.[43] Each PTCA carried about 1% to 1.8% risk of procedure-related death.[54,55,56,57]


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