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[Effect of aorto-coronary bypass on function of cardiac ventricles as evaluated by non-invasive techniques during a
T Petelenz1, K Singer, B Gabrylewicz
1III Kliniki Kardiologii Slaskiej AM.
Insights
Aortocoronary bypass surgery significantly reduced anginal pain and improved exercise tolerance in ischemic heart disease patients. However, right ventricle function showed no significant improvement over two years.
Area of Science:
- Cardiology
- Cardiac Surgery
- Clinical Medicine
Context:
- Ischemic heart disease (IHD) affects millions globally, necessitating effective revascularization strategies.
- Aortocoronary bypass surgery is a common intervention for severe IHD.
- Evaluating long-term outcomes of bypass surgery is crucial for patient management.
Purpose:
- To assess the efficacy of aortocoronary bypass surgery in patients with ischemic heart disease.
- To evaluate the impact of surgery on anginal pain, exercise tolerance, and cardiac ventricle function.
- To identify patient subgroups who may benefit most from coronary revascularization.
Summary:
- A 24-month follow-up study of 35 patients who underwent aortocoronary bypass for IHD showed significant pain reduction (85% free from angina) and improved exercise tolerance.
- Non-invasive tests including ECG, echocardiography, and exercise testing assessed revascularization effectiveness.
- No correlation was found between incomplete revascularization and recurrent angina; right ventricle function showed no significant improvement.
Impact:
- Coronary artery bypass grafting improves quality of life by alleviating angina and enhancing physical capacity in IHD patients.
- Patients without prior myocardial infarction demonstrated better cardiac function post-surgery, suggesting they are better candidates for revascularization.
- Findings guide surgical decision-making and highlight the importance of pre-operative cardiac status.
Abstract:
In 1989-1990, 892 patients with ischemic heart disease were treated at the III Department of Cardiology in Katowice-Ochojec. Aortocoronary bypass was performed in 51 (5.7%) of these patients. Thirty five out of these patients were followed-up for 24 months after surgery. They reported to the hospital for evaluation after 3, 6, 12 and 14 months following a discharge. Efficiency of revascularization was checked with physical examination, and non-invasive tests such as electrocardiography, echocardiography and exercise tolerance testing. Diastolic and symbolic functioning of left and right ventricle was assessed separately. All patients suffered from anginal pain before surgery whereas 85% of operated patients were free from pain. No correlation between incomplete revascularization and recurrence of the anginal pain was noted. Surgery produced an increase in exercise tolerance and maximal load. No significant improvement in the right ventricle was seen during a 2-year follow-up. In the group of patients without previous myocardial infarction measured parameters of cardiac ventricles functioning were better than those in patients who had myocardial infarction. Therefore, the former are better candidates to coronary vessels revascularization.