van Domburg, R. T. et al. The clinical outcome after coronary bypass surgery: a 30-year follow-up study. Eur. Heart J. 30, 453–458 (2009).

The first groups of patients to receive CABG surgery survived for almost 18 years. However, most required repeat revascularization, which prompted researchers at the Erasmus Medical Centre in the Netherlands to conclude that “the classic venous bypass technique is a useful but palliative treatment of a progressive disease”.

CABG surgery is aimed at providing symptomatic relief, improved quality of life and increased life expectancy for patients with severe angina. Ron van Domburg, a clinical epidemiologist at Erasmus Medical Centre, has been interested in assessing the benefits of the procedure, particularly to determine life expectancy after surgery. When he began his work in the early 1980s, CABG surgery was not performed routinely and waiting lists were long. Often patients had to wait for up to a year before receiving surgery, which meant that there was a selection bias—“only the strongest patients survived the long waiting lists,” van Domburg commented.

Almost thirty years on, van Domburg and colleagues have now compiled and evaluated data on the first 1,041 CABG patients from Erasmus Medical Centre. Their study—the most complete follow-up of patients who have undergone CABG surgery, and unique in providing an accurate assessment of prognosis without the need for extrapolations—shows a life expectancy of almost 18 years. The researchers are now focusing on the influence of specific risk factors, such as smoking, on life expectancy after CABG surgery.