Myocardial revascularisation in patients with severe left ventricular dysfunction. Early and midterm results

Area of Science:

• Cardiology
• Cardiac Surgery
• Cardiovascular Research

Background:

• Severe left ventricular dysfunction poses significant risks for patients with coronary artery disease.
• Myocardial revascularization is a critical treatment option, but its safety in patients with compromised left ventricular function requires careful evaluation.

Purpose of the Study:

• To assess the early and midterm outcomes of elective coronary artery bypass graft (CABG) surgery in patients with severe left ventricular dysfunction.
• To determine the safety and efficacy of CABG in improving cardiac function and patient survival in this high-risk population.

Main Methods:

• Retrospective analysis of 97 consecutive patients with coronary artery disease and ejection fraction ≤25% who underwent elective CABG.
• Preoperative and postoperative assessment of left ventricular function using echocardiography (ECHO), cardiac index (CI), and left ventricular end-diastolic pressure (LVEDP).
• Evaluation of early mortality, postoperative complications, and midterm survival rates up to two years post-surgery.

Main Results:

• Early postoperative mortality was 4.1%, with 25% experiencing complications.
• Two-year survival rate was 95.7%.
• Left ventricular ejection fraction (LVEF) significantly improved from 23.1% preoperatively to 36.0% postoperatively (p < 0.05).

Conclusions:

• Elective myocardial revascularization via CABG can be performed safely in patients with severe left ventricular dysfunction and signs of myocardial viability.
• The procedure is associated with acceptable operative mortality, good midterm survival, and significant improvements in left ventricular function, symptom relief, and quality of life.