Myocardial revascularization in patients with severe ischemic left ventricular dysfunction. Long term follow-up in 141 patients

Bouchart, F; Tabley, A; Litzler, P.Y.; Haas-Hubscher, Catherine; Bessou, Jean–Paul; Soyer, R

doi:10.1016/s1010-7940(01)00982-4

Cited by 90 publications

(92 citation statements)

References 20 publications

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“…6,7) Recent studies have reported early postoperative mortality rates of 1.7%-11% in patients with LVD. 1,[6][7][8][9][10][11][12][13][14][15][16][17] The operative mortality rate in this study (2.5%) was similar to that reported in other studies, indicating the safety of the off-pump technique for patients with LVD.…”

Section: Discussionsupporting

confidence: 85%

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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Section: Discussionsupporting

confidence: 85%

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

Fukui

Tabata

Takanashi

2014

ATCS

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“…The operative mortality rate in patients undergoing CABG is associated with several risk factors as female gender, advanced age, obesity, severity of coronary artery disease, low cardiac index, preoperative cardiac failure etc 5,7,11 . Less invasive cardiac surgical procedures are gaining increased interest among the surgical community.…”

Section: Discussionmentioning

confidence: 99%

“…However, as many earlier and current studies demonstrate coronary artery bypass graft (CABG) procedure have improved long term survival in patients with impaired ventricular function [1][2][3][4][5][6] over the last fi fteen years. The benefi t is most obvious in patients with severe LV dysfunction with ejection fraction (EF) less then 35 % 1 and signs of myocardial viability.…”

Section: Introductionmentioning

confidence: 99%

“…Left ventricular function is an important predictor of early postoperative and late morbidity and mortality 4 . Despite improvement in surgical techniques, myocardial protection and postoperative care, the surgical risk remains high [3][4][5]9 and the procedure is still a major surgical challenge. There are however few options for alternative treatment.…”

Section: Introductionmentioning

confidence: 99%

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Myocardial Revascularisation in Patients With Severe Left Ventricular Dysfunction. Early and Midterm Results

Škorpil¹,

Brát²,

Docekal³

et al. 2004

BIOMED PAP

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Aims: This retrospective study evaluates early and midterm results in patients with severe left ventricular dysfunction.Technique: Ninety-seven consecutive patients with coronary artery disease and ejection fraction of left ventricle (LVEF) less or equal to 25 % underwent elective coronary artery bypass graft procedure between September 1998 and December 2001. Mean age at operation was 66 (47-86) years. The main symptoms were angina class III-IV Canadian Cardiovascular Society (CCS) in 78 patients (80 %) and dyspnoea class III-IV New York Heart Association (NYHA) in 43 patients (44 %). The major indications for surgery were severe angina, dyspnoea in 90 patients (93 %). Cardiac index (CI), echocardiography (ECHO), planimetry, end-diastolic pressure of left ventricle (LVEDP), end-diastolic diameter of left ventricle (LVEDd) were used to access left ventricular function preoperatively. ECHO was also used to access left ventricular function postoperatively.Results: Early postoperative (30 days) mortality was 4.1 %. Complications had 25 patients (26 %) postoperatively. Two years survival was 95.7 %. Class III-IV CCS and/or NYHA had 17 patients (17.5 %) two years after surgery. LVEF (assessed by ECHO) improved from 23.1 % preoperatively to 36.0 % postoperatively (p < 0.05).Conclusion: The study showed that elective myocardial revascularisation in patients with severe left ventricular dysfunction and signs of myocardial viability is not necessarily associated with high operative mortality. It can be performed safely with respectable midterm survival in concordance with left ventricular function improvement, symptom relief and quality of life improvement.

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“…7 Coronary artery bypass grafting with the use of the left internal mammary artery (LIMA) and vein grafts is the standard and widely accepted surgical approach in the treatment of coronary artery disease. 8 Vasospasm of the arterial grafts is a serious perioperative complication and may result in IMA hypoperfusion syndrome with its high mortality. 9 The reversibility of LV dysfunction depends on factors including the presence and extent of stunned and hibernating myocardium, the surgeon's ability to completely revascularize hibernating tissue, perioperative myocardial infarction and post-operative graft complication.…”

Section: Introductionmentioning

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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Myocardial revascularization in patients with severe ischemic left ventricular dysfunction. Long term follow-up in 141 patients

Cited by 90 publications

References 20 publications

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

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

Myocardial Revascularisation in Patients With Severe Left Ventricular Dysfunction. Early and Midterm Results

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

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