Physical and psychosocial outcomes after coronary artery bypass graft surgery: review of the literature

Article Abstract:

Coronary artery bypass graft (CABG) surgery is a procedure in which a portion of a healthy vein is attached to a blocked heart vessel (coronary artery), rerouting the flow of blood past the blockage and restoring blood flow to the heart. This operation is often done in patients suffering from chest pain with heart disease caused by the accumulation of fatty substances in the coronary arteries. In 1984, 202,000 CABG operations were performed, costing more than 3 billion dollars. A recent study reviewed the literature on CABG procedures and evaluated the issues concerning prolongation of life, relief from chest pain, ability to return to work, and improvement in the patient's life-style. Controversy exists as to whether or not CABG surgery prolongs life. A recent study by the Coronary Artery Surgery Study on CABG patients and cardiac patients who did not have surgery found no difference in five-year survival rates. However, seven-year survival rates were significantly higher in CABG patients. CABG-treated patients also had a greater amount of relief from chest pain than unoperated patients and required less medication. These patients also had a greater improvement in their tolerance for exercise. No differences between CABG-treated and unoperated patients have been reported concerning the resumption of work and social activities. In both groups, patients younger than 55 years were more likely to return to work than older patients, and men were more likely to resume employment than women. In conclusion, CABG surgery may prolong long-term survival and decrease chest pain, but it is questionable if CABG surgery improves the likelihood of a patient returning to the workplace or his prior lifestyle. (Consumer Summary produced by Reliance Medical Information, Inc.)

Social aspects, Evaluation, Surgery, Myocardial revascularization, Heart, Heart surgery

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Predictors of physical functioning after a cardiac event

Article Abstract:

Persons who have experienced a major cardiac event, such as a myocardial infarction (MI; heart attack), coronary artery bypass graft surgery (CABG), or percutaneous transluminal coronary angioplasty (PTCA), endure both physical and emotional stress. One of the most important subjective responses after such events is the patient's appraisal of his or her residual performance and activity capabilities. This study, involving 46 patients recovering from recent cardiac events, investigated factors associated with subjective and objective measures of physical functioning. Higher functioning levels accompanied positive health appraisals, greater expectation of performance capabilities, and higher self-esteem. Diminished function and increased depression accompanied protracted symptoms, severe illness, and real or anticipated reduction in activity levels. Exercisers experienced less depression than nonexercisers. Greater physical activity and increased feelings of mastery were accompanied by reduced depression. More studies are required to evaluate the relation between objective and subjective physical functioning, as well as the relation between patients' perceptions and their actual physiologic status. (Consumer Summary produced by Reliance Medical Information, Inc.)

Cardiovascular diseases, Heart attack, Cardiac patients, Transluminal angioplasty, Balloon angioplasty, Activities of daily living

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