Aortocoronary bypass in patients with severe left ventricular dysfunction.

Abstract

The results of aortocoronary bypass grafting in 29 patients with severe left ventricular dysfunction (ejection fraction less than 35%) were studied. All patients had severe angina pectoris; 17 patients has class IV heart function and 12 had class III function according to the New York Heart Association classification. Intra-aortic balloon pump support was instituted preoperatively in all patients. Three patients died in the perioperative period. Survivors were followed up for a mean period of 20 months; there were three late deaths. Sixteen patients were clinically improved; 8 had class I and 8 class II heart function at follow-up. Fourteen patients underwent cardiac catheterization postoperatively at a mean time of 19 months. Although 22 (79%) of the 28 grafts were patent, there was no significant improvement in resting left ventricular dysfunction as assessed by ejection fraction, left ventricular volume or left ventricular end-diastolic pressure. Furthermore, graft patency could not be correlated with improvement in segmental wall motion. There was a 10% operative and an 11.5% late mortality and no measurable improvement in resting left ventricular function in this study but the majority (73%) of the surviving patients experienced definite clinical improvement.

• Authors: D E Johnstone, A G Adelman, M Weingert, V F Huckell, B S Goldman
• Journal: Canadian journal of surgery. Journal canadien de chirurgie (Can J Surg) Vol. 23 Issue 2 Pg. 127-31 (Mar 1980) ISSN: 0008-428X [Print] Canada
• PMID: 6965880 (Publication Type: Journal Article)

Topics

• Angina Pectoris (surgery)
• Cardiac Output
• Coronary Angiography
• Coronary Artery Bypass
• Coronary Disease (diagnosis, diagnostic imaging, surgery)
• Diastole
• Female
• Graft Survival
• Heart Ventricles
• Humans
• Male
• Middle Aged
• Postoperative Complications
• Pressure