[The long-term results of aortocoronary bypass surgery in patients with a severe preoperative left ventricular dysfunction].
We analyze retrospectively the short- and long-term results of coronary artery bypass surgery in 50 patients with severe left ventricular dysfunction operated in a period of 11 years. Sixty-six percent of patients had unstable angina and 12% of total presented angina post-acute postmyocardial infarction. Thirty-eight percent of patients were in preoperative functional class III-IV of NYHA. Three-vessel disease was present in 70% of the patients, two-vessel in 30%, and the main trunk was affected in 12% of the global. Hospital mortality was 4% (2/50) due to low cardiac output syndrome. Follow-up was available in all the survivors and ranged 6 months-11 years (mean: 4.8 +/- 3.1). During follow-up, 13 patients died, but in only six was due to cardiac cause. The 35 patients followed were in functional class I-II of NYHA. Eighty-eight percent of the patients were angina free at follow-up. Actuarial analysis, after exclusion of 3 patients who died of causes no directly related to the heart, showed an intrahospital survival rates of 96%; at first year was 92, at 3rd was 78%, and 5th year survival rates were 75%. In conclusion, patients with symptomatic angina and preoperative severe left ventricular dysfunction, coronary artery bypass graft has a low hospital mortality, is effective in improving angina and heart failure, and the long-term survival is acceptable.
Caralps
J M
JM
Unidad de Cirugía Cardíaca, Hospital de la Santa Creu i Sant Pau, Barcelona.
Martí
V
V
Chávez
J
J
Lapiedra
O
O
Cámara
M L
ML
Padró
J M
JM
Arís
A
A
Casas
J I
JI
D000206:Actuarial Analysis; D000208:Acute Disease; D000367:Age Factors; D001026:Coronary Artery Bypass / Q000401:mortality / Q000706:statistics & numerical data; D003327:Coronary Disease / Q000150:complications / Q000401:mortality* / Q000601:surgery; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D012189:Retrospective Studies; D012737:Sex Factors; D013030:Spain; D016277:Ventricular Function, Left
Resultados a largo plazo de la cirugía de bypass aortocoronario en pacientes con disfunción ventricular izquierda severa preoperatoria.