Icelandic heart bypass patients show strong long-term outcomes

Long-term outcomes after coronary artery bypass surgery in Iceland are very good, while the number of operations has fallen substantially over the past two decades, mbl.is reports. The number performed in Iceland is now half that in Sweden, according to a study by researchers at the University of Iceland’s Faculty of Medicine.

The study covered 2,337 operations at Landspítali, Iceland’s national hospital, from 2001 to 2021. Three-quarters of patients were alive 10 years after surgery, and long-term outcomes were comparable for patients operated on with a heart-lung machine and those operated on while the heart was still beating. The researchers said the results were on a par with those of larger heart surgery departments abroad.

The groups also had similar rates of heart attacks and need for coronary artery procedures. Fewer than one per cent of patients in either group needed another bypass operation.

Lead author Kristjana Lind Ólafsdóttir, a fifth-year medical student at the University of Iceland, worked on the research for three years under the supervision of Tómas Guðbjartsson, a professor and senior physician in heart and lung surgery at Landspítali.

Bypass surgery is commonly used for patients with widespread coronary artery disease or narrowing in the heart’s left main artery. Most operations use a heart-lung machine to stop the heart temporarily. Operations on a beating heart now account for less than one per cent of bypass procedures in Iceland, and are generally used for patients with impaired kidney function or extensive calcium in the ascending aorta.

The study reports that the annual rate of bypass operations fell from 42 per 100,000 residents at the beginning of the study period to 13.