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Related Experiment Videos

Coronary bypass in left heart failure.

John Elefteriades1, Randy Edwards

  • 1Section of Cardiothoracic Surgery, Yale University School of Medicine, New Haven, CT 06510, USA.

Seminars in Thoracic and Cardiovascular Surgery
|May 4, 2002
PubMed
Summary

Coronary artery bypass grafting significantly benefits patients with advanced ischemic cardiomyopathy, improving heart function, symptoms, and long-term survival. This surgery is a strong recommendation for eligible patients.

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Area of Science:

  • Cardiology
  • Cardiac Surgery

Background:

  • Advanced ischemic cardiomyopathy significantly impairs left ventricular function.
  • Coronary artery bypass grafting (CABG) is increasingly considered for these patients.

Purpose of the Study:

  • To evaluate the short- and long-term outcomes of CABG in patients with severely reduced ejection fraction (EF).

Main Methods:

  • Analysis of 188 consecutive patients with EF ≤ 30% undergoing CABG by a single surgeon.
  • Assessment of surgical safety, left ventricular function, symptomatic status, and long-term survival.

Main Results:

  • Low operative mortality (2.8% in elective cases).
  • Significant improvement in ejection fraction (from 23.3% to 33.2%).
  • Marked symptomatic improvement (NYHA class from 3.1 to 1.4) and good long-term survival (88%, 77%, 60% at 1, 3, 5 years).
  • Beneficial reverse remodeling observed even in enlarged ventricles.

Conclusions:

  • CABG is safe and effective for advanced ischemic cardiomyopathy.
  • Surgical revascularization offers survival and functional benefits comparable to heart transplantation.
  • Patient selection should not be solely based on EF or LV size if severe coronary artery disease is present.

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