Clinical results of coronary revascularization in left ventricular dysfunction.

Abstract

BACKGROUND: In the present study 15 years of experience with surgical coronary artery bypass grafting (CABG) in patients with left ventricular (LV) dysfunction were retrospectively analyzed.

METHODS AND RESULTS: Between August 1990 and May 2005, a total of 120 patients with severe LV dysfunction (LV ejection fraction (EF)<or=30%) caused by coronary artery disease underwent CABG (mean age 60.3 years, 94 males) Among the 120 patients, 102 had 3-vessel or left main disease. Mean LVEF was 23.5%, and 75% of patients were New York Heart Association functional class III or IV. CABG was performed in all patients with a mean of 2.9 distal grafts/patient. There were 13 hospital deaths (11%). Mean LVEF improved to 32% postoperatively, and further improved to 39% at a mean follow-up of 57.6 months (p<0.05). During the follow-up period, 2 cardiac-related deaths occurred. Kaplan-Meier survival rates at 1, 5 and 10 years were 87.7%, 80.9%, and 44.4%, respectively, and respective freedom from cardiac-related event rates were 96.5%, 90.3% and 63.5%.

CONCLUSIONS: CABG in patients with severe LV dysfunction provides optimal survival with an improved EF and functional state, and may provide a good alternative to transplantation in selected patients.