Long-term survival and functional recovery after isolated coronary artery bypass grafting in patients with severe left ventricular dysfunction.

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
• Journal: General thoracic and cardiovascular surgery (Gen Thorac Cardiovasc Surg) Vol. 55 Issue 10 Pg. 403-8 (Oct 2007) ISSN: 1863-6705 [Print] 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-Meier 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)