La rivascolarizzazione miocardica nei pazienti con funzione ventricolare sinistra severamente depressa.

Translated title of the contribution: Myocardial revascularization in patients with severely depressed left ventricular function

F. Nicolini, A. Carcagnì, E. Citterio, G. Franciosi, D. Gastaldi, M. Longo, E. Manasse, A. Bandera, R. Gallotti

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Improvements in anesthetic and surgical management of patients with left ventricular dysfunction have resulted in a decline in perioperative mortality and morbidity. Nevertheless, coronary artery bypass grafting (CABG) in patients with left ventricular ejection fraction <or = 0.30 remains a surgical challenge. METHODS: Fifty-one patients with end-stage coronary artery disease and left ventricular ejection fraction between 16 and 30% underwent CABG. Mean age at operation was 66.1 +/- 7.85 years. Selection criteria included the clinical diagnosis of ischemic heart disease with angiographic demonstration of critical coronary artery obstructive lesions. Mean number of grafts per patient was 2.94 (range 1-5). Average duration of cardiopulmonary bypass was 74.5 +/- 22.4 min and mean aortic cross clamp time was 47.6 +/- 17 min. RESULTS: No operative and in-hospital deaths occurred. Eight patients (15.7%) had postoperative low cardiac output syndrome, requiring intraaortic balloon counterpulsation. There were two major neurological complications (3.9%). There were four late deaths (7.8%), due to recurrence of untreatable congestive heart failure. Left ventricular ejection fraction increased from a mean of 25.51 +/- 4.75% preoperatively to 31.35 +/- 9.9% postoperatively (p <0.001). Improvement in NYHA functional class (preoperatively 2.98 +/- 0.79 vs 2.35 +/- 0.6 postoperatively, p <0.001) was found in this group at follow-up. CONCLUSIONS: CABG leads to an excellent prognosis in high risk patients with ischemic heart disease and low left ventricular ejection fraction, improving their functional and clinical outcome and consequently their life expectancy.

Translated title of the contributionMyocardial revascularization in patients with severely depressed left ventricular function
Original languageItalian
Pages (from-to)535-541
Number of pages7
JournalCardiologia
Volume44
Issue number6
Publication statusPublished - Jun 1999

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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