• Gen Thorac Cardiovasc Surg · Oct 2007

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

    • Toshihiro Fukui, Toshihiko Shibata, Yasuyuki Sasaki, Hidekazu Hirai, Manabu Motoki, Yosuke Takahashi, Atsushi Nakahira, and Shigefumi Suehiro.
    • Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, Osaka, and Kansai Rosai Hospital, Hyogo, Japan. tfukui-cvs@umin.ac.jp
    • Gen Thorac Cardiovasc Surg. 2007 Oct 1; 55 (10): 403-8.

    ObjectiveCoronary 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.MethodsWe 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.ResultsThe 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%.ConclusionCABG 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.

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