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Coronary artery bypass in patients with severe left ventricular dysfunction
Dronamraju Dilip1, Mangu H Rao, Abha Chandra
1Department of Cardiovascular and Thoracic Surgery Sri Venkateswara Institute of Medical Sciences Tirupati, Andhra Pradesh, India. drdilip_d@yahoo.com
Asian Cardiovascular & Thoracic Annals
|September 6, 2002
Summary
Coronary artery bypass grafting in patients with severe left ventricular dysfunction shows acceptable mortality. This surgery can significantly improve quality of life, moving patients from severe angina to a better functional class.
Area of Science:
- Cardiology
- Cardiac Surgery
- Internal Medicine
Background:
- Severe left ventricular dysfunction (ejection fraction < 30%) presents significant challenges for cardiac surgery.
- Patients with poor ejection fraction often have complex comorbidities, including hypertension, diabetes, and hypercholesterolemia.
Purpose of the Study:
- To evaluate the safety and efficacy of coronary artery bypass grafting (CABG) in patients with severe left ventricular dysfunction.
- To assess the impact of CABG on mortality, hospital stay, and quality of life in this high-risk patient group.
Main Methods:
- Retrospective review of 82 patients with ejection fraction < 30% who underwent CABG between March 1993 and February 2000.
- Analysis of perioperative mortality, hospital stay duration, and long-term functional status (Canadian Cardiovascular Society angina class).
Main Results:
- The study included patients aged 28-76 years, with a high prevalence of hypertension (93%) and diabetes mellitus (85%).
- Perioperative mortality within 48 hours was 9% (7 patients). Mean hospital stay was 7 ± 2 days.
- At 1-year follow-up, 90% of surviving patients improved from Canadian Cardiovascular Society angina class III to class I.
Conclusions:
- Coronary artery bypass grafting in patients with severe left ventricular dysfunction is associated with an acceptable mortality risk.
- CABG can lead to a significant improvement in quality of life and functional capacity in this patient population.