Long-term results of coronary artery bypass grafting procedure in the presence of left ventricular dysfunction and hibernating myocardium

Lorusso, Roberto; Canna, Giovanni La; Ceconi, Claudio; Borghetti, Valentino; Totaro, Pasquale; Parrinello, Giovanni; Coletti, Giuseppe; Minzioni, Gaetano

doi:10.1016/s1010-7940(01)00945-9

Cited by 49 publications

(44 citation statements)

References 21 publications

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“…In our study, dobutamine stress echocardiography was performed preoperatively in all patients by the same cardiologist, and thallium-201 rest-redistribution scintigraphy was performed in 43 (57%) patients. Both techniques are valuable in the identification of hibernating myocardium and in the prediction of a favorable postoperative outcome [13]. We confirmed in earlier research [9] that the preoperative presence of hibernating myocardium is a predictor of immediate postoperative improvement of left ventricular function in these patients.…”

Section: Assessment Of Hibernating Myocardium and Patient Selectionsupporting

confidence: 85%

“…Our finding supports the observation of Lansman and colleagues [21], who stated that the presence of angina predicted a good survival rate and a consistent improvement in left ventricular function. However, other investigators [13] have shown that the presence of angina had no statistically significant predictive value with regard to long-term mortality and the recurrence of heart failure. Dreyfus and colleagues [22] emphasized the importance of using viability tests instead of clinical evaluation as a crucial determinant of patient selection and subsequent postoperative outcome.…”

Section: Predictors Of Late Outcomementioning

confidence: 87%

“…Data on the long-term results of CABG in patients with impaired left ventricular function are few [13,17]; therefore, we conducted this prospective study of selected patients with compromised left ventricular function. Eight years after CABG, 89.3% of the patients in our series were alive.…”

Section: Patient Survivalmentioning

confidence: 99%

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Long-Term Results of Coronary Artery Bypass Grafting in Patients With Left Ventricular Dysfunction

Hamad

Tan

Straten

et al. 2008

The Annals of Thoracic Surgery

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Background. In this prospective study, we investigated the determinants of long-term outcome, symptoms, and left ventricular function after coronary artery bypass grafting in patients with a moderate to severely decreased left ventricular ejection fraction.Methods. Between 1997 and 1998, 75 consecutive patients with moderate to severe left ventricular dysfunction underwent coronary artery bypass grafting procedures. The operative mortality rate was 4.0%, and the 72 survivors were monitored for 8 years. The end points were mortality, symptomatic status (New York Heart Association [NYHA] functional class), and left ventricular function.Results. The total survival rate after 8 years was 89.3%. During follow-up, 8 patients died. Death was attributed to a cardiac cause in 5 patients and to a noncardiac cause in 3. There was no statistically significant difference between preoperative and late postoperative NYHA functional class, despite a statistically significant im-

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Section: Assessment Of Hibernating Myocardium and Patient Selectionsupporting

confidence: 85%

Section: Predictors Of Late Outcomementioning

confidence: 87%

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Long-Term Results of Coronary Artery Bypass Grafting in Patients With Left Ventricular Dysfunction

Hamad

Tan

Straten

et al. 2008

The Annals of Thoracic Surgery

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“…The recent trends in CABG procedure have clearly favoured the use of arterial conduits, not only to perfuse the LAD in normal left ventricular function but also in patients with impaired left ventricular function. 19 Jegaden et al, however, recently reported on potential unfavourable effects of extensive use of arterial grafts as compared to more conventional surgical management (LIMA plus vein grafts) to revascularize patients affected by impaired LV function, documenting increased rate of perioperative complications and no benefit as far as survival was concerned. They found significant increase in post-operative LV function in venous group.…”

Section: Resultsmentioning

confidence: 99%

A comparison of left ventricular function in patients undergoing beating heart bypass surgery using mixed versus pure venous conduits

et al. 2017

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Background: The pathophysiology of coronary artery disease was established in 1876 by Adam Hammer when he postulated that angina is caused by interruption of coronary blood supply and that myocardial infarction occurred after the occlusion of at least one coronary artery. Aims of the study were to compare the left ventricular function in patients who have undergone beating heart bypass surgery using mixed (internal mammary artery and venous conduits) versus pure Venous conduits, and to compare the incidence of postoperative complications.Methods: It was an observational, analytical study. All patients admitted with triple vessel disease requiring CABG (n=50), with ejection fraction >30%, were subjected to either left internal mammary artery and venous conduits (group A, n=25) or only venous conduits (group B, n=25). Patient who had undergone prior surgical myocardial revascularization, preexisting valvular disease, any evidence of raised pulmonary arterial pressure more than 40/15 mmHg, operated using cardiopulmonary bypass machine, pre-operative use of Intra-Aortic Balloon Pump, any history of neurological dysfunction/Transient ischemic attack, left atrium size more than 5.5 cm were excluded from the studyResults: Improvement in left ventricular function after coronary artery bypass grafting was objectively demonstrated in both the groups. There was a statistically significant increase in mean LVEF in group B (56.16±4.13) compared to group A (51.96±5.30) at 3 months of follow up (p=0.009). The most common complication in both the groups were atrial fibrillation group A=36% (n=9), group= B 16 % (n=4), renal failure group A=12% and group B=8% and sternal wound infection. The post-operative bleeding (Drain output) in first 24 hours was similar in both the groups, 295.56 ml in group A and 265.20ml in group B (p=) with similar hospital stay (group A=9days, group B=8.5days).Conclusions: Patients with venous conduits have better postoperative LVEF as compared to Mixed conduit with similar rate of post-operative complications.

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“…Multiple revascularizations to viable and hibernating myocardium may improve myocardial contractility and cardiac function even though global function is severely impaired. 1) Recent meta-analysis demonstrated that CABG can be performed with acceptable operative mortality and 5-year actuarial survival rates in patients with LVD. 2) Advances in surgical techniques (such as off-pump techniques and arterial grafts), myocardial protection, and postoperative management have contributed to improving outcomes in these high-risk patients.…”

Section: Introductionmentioning

confidence: 99%

Long-Term Outcomes after Off-Pump Coronary Artery Bypass Grafting in Left Ventricular Dysfunction

Fukui

Tabata

Takanashi

2014

ATCS

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Purpose:We assessed the long-term clinical, angiographic, and echocardiographic outcomes of patients with left ventricular dysfunction (ejection fraction ≤40%) who underwent isolated off-pump coronary artery bypass grafting. Methods: One hundred sixty one patients were included. Mean age was 67.2 ± 11.4 years, and 20 patients (12.4%) were female. Eighty-eight patients (54.7%) were New York Heart Association functional class 3 or 4. Early postoperative and follow-up angiography and echocardiography fi ndings were analyzed, and mid-term survival rates (mean follow-up 40.7 ± 25.6 months) were calculated. Results: Mean number of distal anastomoses was 4.4 ± 1.3. Bilateral internal thoracic artery grafts were used in 84.5% of patients. Operative mortality was 2.5%. Early patency rate of anastomoses was 98.3%. Early postoperative ejection fraction improved from 33.1 ± 5.6% preoperatively to 36.9 ± 9.5% (p <0.001). Seven-year survival rate was 73.9 ± 5.3%, and freedom from cardiac events rate was 68.5 ± 5.2%. One-year patency rate of anastomoses was 85.8%. Follow-up ejection fraction was 39.1 ± 10.7% ( p <0.001). Conclusions: Early and long-term outcomes of off-pump coronary artery bypass grafting in patients with left ventricular dysfunction were favorable, including early postoperative and follow-up patency rates of anastomoses and echocardiographic recovery of ejection fraction.

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Long-term results of coronary artery bypass grafting procedure in the presence of left ventricular dysfunction and hibernating myocardium

Cited by 49 publications

References 21 publications

Long-Term Results of Coronary Artery Bypass Grafting in Patients With Left Ventricular Dysfunction

Long-Term Results of Coronary Artery Bypass Grafting in Patients With Left Ventricular Dysfunction

A comparison of left ventricular function in patients undergoing beating heart bypass surgery using mixed versus pure venous conduits

Long-Term Outcomes after Off-Pump Coronary Artery Bypass Grafting in Left Ventricular Dysfunction

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