Ventricular function and the native coronary circulation five years after myocardial revascularization.
Of 531 patients who underwent coronary artery bypass grafting during 1970 to 1973, 181 were restudied by ventriculography and by graft and coronary angiography at least 5 years following operation. Five patterns of postoperative ventricular function were identified: improved ventricular function resulting in normal left ventricular (LV) function; normal ventricular function that was unchanged; abnormal ventricular function that improved but did not reach normal; abnormal ventricular function that remained unchanged; and deterioration of LV function. Patients who regained (40) and those who retained normal ventricular function (49) comprise 49% of the series and patients with deterioration of ventricular function, only 20%. Graft patency and angina relief were significantly better in those with normal LV function than in those with LV deterioration. Progression of disease in grafted coronary arteries was similar in all groups, but was significantly higher in ungrafted coronary arteries (61.3%) in the patients showing deterioration than in either the improved patients or those with an unchanged normal LV (33.3% each) (p less than 0.05). The high incidence of progression of disease in ungrafted coronary arteries in the group with deterioration suggests that low graft patency and deterioration of ventricular function in this group might both be related to intrinsic acceleration of coronary atherosclerosis unrelated to operative intervention.
D000787:Angina Pectoris; D000790:Angiocardiography; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003326:Coronary Circulation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D009203:Myocardial Infarction