| Abstract | OBJECTIVE: Coronary artery bypass grafting (CABG) in patients with left ventricular dysfunction has been considered to be a challenging operation. We assessed the early angiographic and long-term clinical and functional outcomes of patients with poor left ventricular function who underwent isolated CABG. METHODS: We retrospectively reviewed the records of 78 patients with a poor left ventricular ejection fraction (35% or less) who underwent isolated CABG between January 1991 and November 2006. The mean age of the patients was 66.1+/-9.4 years, and their mean New York Heart Association functional class was 3.1+/-0.8. Their mean end-diastolic left ventricular diameter was 57.4+/-8.1 mm, and their mean grade of mitral regurgitation was 0.7+/-1.0. Early postoperative angiograms were performed at 32.5+/-33.5 days after the operation. Interval echocardiographic data were analyzed, and the long-term survival rate was evaluated. RESULTS: The average number of distal anastomoses per patient was 3.2 +/-1.1. The operative mortality rate was 7.7%. Stroke occurred in 1.3% of patients. The overall patency rates for arterial and venous grafts were 100% and 97.2%, respectively. The left ventricular ejection fraction significantly improved from 28.2%+/-5.1% to 34.4%+/-8.4%. Both the end-diastolic and end-systolic left ventricular dimensions significantly decreased from 57.4+/-8.1 to 55.1+/-8.8 mm and from 47.4+/-8.4 to 45.1+/-9.7, re spectively. The actuarial patient survival rate at 10 years was 73.1%. CONCLUSION: CABG in patients with left ventricular dysfunction was effective, with favorable early graft patency rates. The long-term outcome was also acceptable, with echocardiographic functional recovery. |
| Authors | Toshihiro Fukui, Toshihiko Shibata, Yasuyuki Sasaki, Hidekazu Hirai, Manabu Motoki, Yosuke Takahashi, Atsushi Nakahira, Shigefumi Suehiro
(Affiliation: Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, Osaka, and Kansai Rosai Hospital, Hyogo, Japan. tfukui-cvs at umin.ac.jp)
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| Journal | General thoracic and cardiovascular surgery
(Gen Thorac Cardiovasc Surg)
Vol. 55
Issue 10
Pg. 403-8
(Oct 2007)
ISSN: 1863-6705 Japan |
| PMID | 18018603
(Publication Type: Journal Article)
|
| Topics |
- Aged
- Coronary Angiography
- Coronary Artery Bypass
(adverse effects)
- Coronary Artery Disease
(complications, mortality, pathology, physiopathology, surgery)
- Echocardiography
- Female
- Follow-Up Studies
- Humans
- Kaplan-Meiers Estimate
- Male
- Middle Aged
- Postoperative Complications
(etiology, mortality)
- Proportional Hazards Models
- Recovery of Function
- Research Design
- Retrospective Studies
- Risk Assessment
- Risk Factors
- Severity of Illness Index
- Stroke Volume
- Time Factors
- Treatment Outcome
- Vascular Patency
- Ventricular Dysfunction, Left
(etiology, mortality, pathology, physiopathology, surgery)
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