[Treatment of coronary artery disease with poor left ventricular function: comparison of medical and surgical treatments in relation to the numbers of the diseased vessel].
The operative mortality and short-term (average 20 months) survival of 100 surgically or medically treated patients, who had coronary artery disease with poor left ventricular function, were examined. One hundred patients with myocardial infarction and radionuclide-documented left ventricular dysfunction (LVEF at rest less than or equal to 40%) were subjects of this study; 85 patients among them underwent simultaneous coronary arteriography. Fifty-six patients whose average age was 59.7 years, and an average LVEF was 30.0%, were treated medically; 44 patients with an average age of 56.0 years, and an average LVEF of 30.9%, were treated surgically, 41 with bypass grafts, two with left ventricular surgery, and one with both these procedures. The medically treated patients consisted of four groups. Group I comprised 15 patients, in whom coronary angiography was contraindicated. Their average age was 67.1 and an average LVEF was 26.2%, Group II, included six patients, who had no indication for surgery because of severely diseased distal coronary arteries. This group had an average age of 57.5 years and an average LVEF of 22.5%. There were one with two-vessel disease and five with three-vessel disease. Group III included five surgical candidates who refused surgery. Their average age and an LVEF were 67.0 and 35.0%, respectively. In this group, there were one with two-vessel disease and four with three-vessel disease. Group IV, comprised 22 patients who did not need surgical therapy. Their average age was 55.3 and average LVEF was 32.5%. They included 22 with one-vessel disease, seven with two-vessel disease and one with three-vessel disease.(ABSTRACT TRUNCATED AT 250 WORDS)
Nishimura
S
S
Division of Cardiology, Toranomon Hospital, Tokyo.
Nakanishi
S
S
Nishiyama
S
S
Kato
K
K
Nishikawa
H
H
Seki
A
A
Fuse
K
K
Makuuchi
H
H
Konishi
T
T
Kukita
M
M
D000328:Adult; D000368:Aged; D003327:Coronary Disease / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D003331:Coronary Vessels / Q000473:pathology*; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D013318:Stroke Volume; D015996:Survival Rate; D016277:Ventricular Function, Left