Abstract | OBJECTIVES: BACKGROUND: METHODS: We analyzed the data of 83 consecutive patients (69 men, 14 women, aged 42 to 83 years [mean 66.8]) with a left ventricular ejection fraction < or = 30% who underwent isolated coronary artery bypass grafting (without aneurysmectomy, valve replacement or other open heart procedures) performed by one surgeon during a 6-year period. The ejection fraction ranged from 10% to 30% (mean 24.6%). Preoperatively, 49% of patients had angina, 52% had congestive heart failure (17% with pulmonary edema) and 30% manifested significant ventricular arrhythmia. The mean number of grafts was 2.7/patient. The internal mammary artery was used in 82% of grafts to the left anterior descending coronary artery. The intraaortic balloon pump was required therapeutically (for angina or pump failure) in 19% of patients and was prophylactically placed preoperatively in another 43% of patients. RESULTS: The hospital mortality rate was 8.4% (7 of 83). The mortality rate was 3.3% (2 of 61) in those patients who did not require admission to an intensive care unit immediately before operation. Canadian Cardiovascular Society angina class improved postoperatively by 1.9 categories and New York Heart Association congestive heart failure class by 1 category. Left ventricular ejection fraction (assessed postoperatively in 68 of 76 hospital survivors) improved from 24.6% preoperatively to 33.2% postoperatively (36% increase) (p < 0.001). At 1 and 3 years, respectively, all-cause survival was 87% and 80% and freedom from cardiac death was 89.8% and 84.5%. CONCLUSIONS:
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Authors | J A Elefteriades, G Tolis Jr, E Levi, L K Mills, B L Zaret |
Journal | Journal of the American College of Cardiology
(J Am Coll Cardiol)
Vol. 22
Issue 5
Pg. 1411-7
(Nov 01 1993)
ISSN: 0735-1097 [Print] United States |
PMID | 8227799
(Publication Type: Comparative Study, Journal Article)
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Topics |
- Actuarial Analysis
- Adult
- Aged
- Aged, 80 and over
- Cause of Death
- Coronary Artery Bypass
(methods)
- Defibrillators, Implantable
- Female
- Follow-Up Studies
- Heart Diseases
(classification, diagnosis, mortality, physiopathology, surgery)
- Hospital Mortality
- Humans
- Intra-Aortic Balloon Pumping
- Male
- Mammary Arteries
(transplantation)
- Middle Aged
- Prognosis
- Quality of Life
- Severity of Illness Index
- Stroke Volume
- Survival Rate
- Ventricular Function, Left
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