[The treatment of patients with ischemic heart disease and significant disorder of left ventricular function]

Area of Science:

• Cardiology
• Cardiac Surgery
• Ischemic Heart Disease Research

Background:

• Severe left ventricular contractile dysfunction is a hallmark of advanced ischemic heart disease.
• Medical management of ischemic heart disease with severe left ventricular dysfunction often yields suboptimal outcomes.
• Aortocoronary shunting is a surgical revascularization technique aimed at improving myocardial perfusion.

Purpose of the Study:

• To compare the efficacy of aortocoronary shunting versus medical treatment in patients with ischemic heart disease and severe left ventricular dysfunction.
• To evaluate the impact of surgical intervention on myocardial contractile capacity and long-term survival.
• To assess the incidence of adverse cardiac events in both treatment groups.

Main Methods:

• A cohort of 71 patients with coronarographically verified ischemic heart disease and severe left ventricular contractile disorders was studied.
• Thirty-eight patients underwent aortocoronary shunting.
• The remaining patients received medical treatment.

Main Results:

• Aortocoronary shunting significantly improved myocardial contractile capacity compared to medical therapy.
• Patients undergoing surgery demonstrated longer survival rates.
• Medical treatment was associated with a higher incidence of myocardial infarctions and cardiac insufficiency, often leading to fatal outcomes.

Conclusions:

• Aortocoronary shunting offers superior clinical benefits for patients with ischemic heart disease and severe left ventricular dysfunction.
• Surgical revascularization improves cardiac function and survival while reducing major adverse cardiac events.
• Medical management alone carries a higher risk of complications and mortality in this patient population.