Il trattamento chirurgico della cardiopatiaischemica associata a seyero deficit funzionale del yentricolo sinistro: esperienza con 200 casi

Translated title of the contribution: Coronary artery bypass graft in patients with coronary artery disease and severely depressed left ventricular ejection fraction: Our experience in 200 cases

Pietro Di Biasi, Roberto Scrofani, Stefano Moriggia, Maurizio Di Biasi, Mario Botta, Matteo Mariani, Carmine Santoli

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

BACKGROUND. The study was designed to evaluate short and long-term benefits of coronary artery bypass graft in patients with coronary artery disease and severely depressed left ventricular ejection fraction and to identify contemporary risk factors associated with significantly greater mortality in this high-risk subgroup. METHODS. From 1985 to 1995, 200 consecutive pts with EF≤0.30 underwent CABG. Among these patients, 60% were older than 70 years. NYHA functional class III/IV was present in 31% of pts. Preoperative mean cardiac index was 2.7 ± 7 l/min/m2, mean pulmonary artery pressure was 29.9 ± 7 mm Hg and contractility score (generated by appropriate software for left ventricular kinesis analysis) mean value was 50.1 ± 11.6 points. Urgent operation was required in 32 pts (16%). The majority of pts were completely revascularized. RESULTS. Operative mortality was 9% (18 pts). Low output syndrome was the most common postoperative complication (13.5%) followed by ventricular arrhythmia (8%). mean length of postoperative hospitalization for survivors was 13 ± 10 days. Of 23 possible operative risk factors evaluated, four were associated with significantly greater mortality: cardiac index ≤2.1 l/min/m2, urgent operation, contractility score ≥80 and associated surgical procedures. Survivors experienced significant improvement in CHF class (p<0.001) and follow up EF (p<0.001). Kaplan-Meier estimate of survival at 1 year, 5 years and 8 years was 85%, 65% and 54%. CONCLUSION. Through more careful assessment of preoperative risk factors, patients selection and perioperative management, actually coronary artery bypass graft may be offered to pts with low ejection fraction with reduced morbidity and mortality.

Original languageItalian
Pages (from-to)1139-1147
Number of pages9
JournalGiornale Italiano di Cardiologia
Volume26
Issue number10
Publication statusPublished - 1996

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Coronary Artery Bypass
Stroke Volume
Coronary Artery Disease
Transplants
Mortality
Survivors
Kinesis
Kaplan-Meier Estimate
Patient Selection
Pulmonary Artery
Cardiac Arrhythmias
Hospitalization
Software
Morbidity
Pressure
Survival

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Biasi, P. D., Scrofani, R., Moriggia, S., Biasi, M. D., Botta, M., Mariani, M., & Santoli, C. (1996). Il trattamento chirurgico della cardiopatiaischemica associata a seyero deficit funzionale del yentricolo sinistro: esperienza con 200 casi. Giornale Italiano di Cardiologia, 26(10), 1139-1147.

Il trattamento chirurgico della cardiopatiaischemica associata a seyero deficit funzionale del yentricolo sinistro : esperienza con 200 casi. / Biasi, Pietro Di; Scrofani, Roberto; Moriggia, Stefano; Biasi, Maurizio Di; Botta, Mario; Mariani, Matteo; Santoli, Carmine.

In: Giornale Italiano di Cardiologia, Vol. 26, No. 10, 1996, p. 1139-1147.

Research output: Contribution to journalArticle

Biasi, PD, Scrofani, R, Moriggia, S, Biasi, MD, Botta, M, Mariani, M & Santoli, C 1996, 'Il trattamento chirurgico della cardiopatiaischemica associata a seyero deficit funzionale del yentricolo sinistro: esperienza con 200 casi', Giornale Italiano di Cardiologia, vol. 26, no. 10, pp. 1139-1147.
Biasi, Pietro Di ; Scrofani, Roberto ; Moriggia, Stefano ; Biasi, Maurizio Di ; Botta, Mario ; Mariani, Matteo ; Santoli, Carmine. / Il trattamento chirurgico della cardiopatiaischemica associata a seyero deficit funzionale del yentricolo sinistro : esperienza con 200 casi. In: Giornale Italiano di Cardiologia. 1996 ; Vol. 26, No. 10. pp. 1139-1147.
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abstract = "BACKGROUND. The study was designed to evaluate short and long-term benefits of coronary artery bypass graft in patients with coronary artery disease and severely depressed left ventricular ejection fraction and to identify contemporary risk factors associated with significantly greater mortality in this high-risk subgroup. METHODS. From 1985 to 1995, 200 consecutive pts with EF≤0.30 underwent CABG. Among these patients, 60{\%} were older than 70 years. NYHA functional class III/IV was present in 31{\%} of pts. Preoperative mean cardiac index was 2.7 ± 7 l/min/m2, mean pulmonary artery pressure was 29.9 ± 7 mm Hg and contractility score (generated by appropriate software for left ventricular kinesis analysis) mean value was 50.1 ± 11.6 points. Urgent operation was required in 32 pts (16{\%}). The majority of pts were completely revascularized. RESULTS. Operative mortality was 9{\%} (18 pts). Low output syndrome was the most common postoperative complication (13.5{\%}) followed by ventricular arrhythmia (8{\%}). mean length of postoperative hospitalization for survivors was 13 ± 10 days. Of 23 possible operative risk factors evaluated, four were associated with significantly greater mortality: cardiac index ≤2.1 l/min/m2, urgent operation, contractility score ≥80 and associated surgical procedures. Survivors experienced significant improvement in CHF class (p<0.001) and follow up EF (p<0.001). Kaplan-Meier estimate of survival at 1 year, 5 years and 8 years was 85{\%}, 65{\%} and 54{\%}. CONCLUSION. Through more careful assessment of preoperative risk factors, patients selection and perioperative management, actually coronary artery bypass graft may be offered to pts with low ejection fraction with reduced morbidity and mortality.",
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KW - Coronary artery bypass graft

KW - Ejection fraction

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