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Coronary artery bypass grafting in patients with depressed left ventricular function: operative results and long-term
S Sekine1, R Kuribayashi, T Sakurada
1Department of Cardiovascular Surgery, Akita University School of Medicine, Japan.
Insights
Coronary artery bypass grafting (CABG) significantly improves left ventricular ejection fraction (LVEF) in patients with coronary artery disease and low LVEF. CABG offers safe, effective treatment with excellent long-term survival and symptom relief.
Area of Science:
- Cardiology
- Cardiac Surgery
Background:
- Coronary artery disease (CAD) often leads to depressed left ventricular (LV) function.
- Patients with low LV ejection fraction (LVEF) present a surgical challenge.
Purpose of the Study:
- To evaluate the safety and efficacy of coronary artery bypass grafting (CABG) in patients with CAD and significantly reduced LVEF.
- To assess the impact of CABG on LV function and long-term outcomes.
Main Methods:
- Retrospective study of nine consecutive patients with CAD, LVEF < 0.4, and angina pectoris undergoing CABG.
- Analysis of operative mortality, graft patency, LVEF changes, and long-term survival/symptom status.
Main Results:
- No operative deaths; 92.9% graft patency rate.
- Significant improvement in mean LVEF from 0.37 to 0.53 post-CABG (P < 0.05).
- Four-year actuarial survival rate of 88.9%; 75% of survivors were asymptomatic.
Conclusions:
- CABG is a safe and effective procedure for patients with CAD and depressed LV function.
- CABG leads to significant improvement in LV function and favorable long-term outcomes, including symptom resolution.
Abstract:
Nine consecutive patients with coronary artery disease who had a left ventricular ejection fraction (LVEF) of less than 0.4 and underwent coronary artery bypass grafting (CABG) at our institution were studied. All patients had angina pectoris and six of the nine patients (67%) had a history of congestive heart failure. The mean EF was 0.37 +/- 0.03 and the mean LV end-diastolic pressure was 10.1 +/- 4.9 mmHg. An average of 1.56 +/- 0.50 grafts per patient were placed and there was no operative death. The graft patency rate was 92.9% and the mean EF rose significantly from 0.37 to 0.53 after surgery (P less than 0.05). There was one late death, the 4-year actuarial survival rate being 88.9%. Of the eight long-term survivors, six (75%) were totally asymptomatic and only two had mild angina on exertion. This study confirmed that CABG for patients with depressed LV dysfunction can be performed safely with an acceptably low operative mortality, a significant improvement of LV function, and excellent long-term results.