R E V I E W Outcomes of coronar y ar ter y bypass graft surger y Anna Louise Hawkes1,3 Madeleine Nowak1 Benjamin Bidstrup2 Richard Speare1 1School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, Queensland, Australia (3Currently Queensland Cancer Fund); 2John Flynn Hospital, Gold Coast, Queensland, Australia Correspondence: Anna Hawkes Psycho-oncology Research Unit, Queensland Cancer Fund, PO Box 201, Spring Hill, Queensland, Australia 4006 Tel +61 7 3258 2305 Email annahawkes@qldcancer.com.au Abstract:This review article summarizes the major studies that have investigated the outcomes of coronary artery bypass graft surgery (CABG). The article includes a review of the literature in the areas of: history of CABG; indications for CABG; and measurement of quality of life following CABG, including prolongation of life, physical functioning (ie, relief from angina and dyspnea, physical activity, as well as complications of surgery and re-hospitalization), psychological functioning, and social functioning. Overall, the literature demonstrates that the outcomes of CABG have historically been measured in terms of mortality and morbidity; however, it has now been well recognized that adjustment to CABG is a multidimensional phenomenon that is not fully explained by medical factors. Therefore, in addition to studying mortality and morbidity outcomes following CABG, many recent studies have identified that it is important to investigate various physical, psychological, and social variables that have a significant impact on post-operative adjustment to CABG. Keywords: coronary artery bypass graft surgery, outcomes, quality of life, recovery. Methodology Electronic databases were searched, without language restriction, from January 1966 to January 2006. The databases used included the Cochrane Database of Systematic Reviews, MEDLINE(R), CINAHL, and PsychINFO. Key search terms included: revascularization; coronary artery bypass graft surgery; CABGS; CABG; coronary bypass surgery; percutaneous transluminal coronary angioplasty; PTCA; percutaneous coronary intervention; PCI; mortality; morbidity; quality of life; angina; dyspnea; physical activity; complications; rehospitalization; vocational status; physical functioning; psychological functioning; social functioning; and outcomes. History of coronary artery bypass graft surgery (CABG) In 1962, a cardiac surgeon by the name of Sabiston conducted the first unsuccessful saphenous vein graft from the ascending aorta to the distal right coronary artery and the patient died 3 days later. The technique was then pioneered by Argentinian René Favaloro and others at the Cleveland Clinic in the late 1960s. The next major development was in 1970, when the internal mammary artery was used as a bypass conduit to the coronary arteries. By the mid 1970s, many centers in the United States, Australasia, and Europe were performing CABG with low peri-procedural mortality, and a high rate of pain relief (Pollick 1993). In 1989, the number of procedures performed per 100 000 people was: 26.6 in the United Kingdom, 62.9 in Australia, and 141.8 in the United States (Wise and Graham- Clarke 1994). In Australia, following a tentative start in 1969, CABG is now one of the most common major elective surgical procedures. In 1994, the national cardiac surgery rate in Australia had risen to 108 procedures/100 000 people, with a mortality rate of 2.8% Vascular Health and Risk Management 2006:2(4) 477–484 © 2006 Dove Medical Press Limited. All rights reserved 477