Survival predictors in patients with a left ventricular ejection fraction of 10-30% receiving a coronary bypass: analysis of preoperative variables.
A total of 224 patients with angina pectoris and a left ventricular ejection fraction in the range of 10-30% (mean 24.2%) underwent coronary artery bypass grafting between April 1986 and August 1991. These patients received a mean (s.d.) of 2.9 (0.3) aortocoronary vein grafts. The overall operative mortality rate was 8.9%. The 1-, 2- and 3-year survival rates were 87.7%, 86.7% and 85.2%, respectively. Analysis of operative risk factors showed that patients with an end-diastolic left ventricular pressure > 24 mmHg were significantly more at risk (mortality rate 20.0%, P < 0.05) than those with an end-diastolic left ventricular pressure < or = 24 mmHg (mortality rate 6.2%). Patients with a perioperative cardiac index < 2.5 l min-1m-2 had higher mortality (25.4%) than those with a cardiac index > or = 2.5 l min-1m-2 (mortality 1.9%, P < 0.001). The operative mortality rate of patients with a cardiac index < 2.5 l min-1m-2 and an end-diastolic left ventricular pressure > 24 mmHg was 40.5%. Patients with a left ventricular ejection fraction of 10-20% were not significantly more at risk (P > 0.05) than those with a left ventricular ejection fraction of 21-30%.
Hausmann
H
H
Department of Thoracic and Cardiovascular Surgery, German Heart Institute, Berlin.
Warnecke
H
H
Ennker
J
J
Topp
H
H
Schiessler
A
A
Hempel
B
B
Friedel
N
N
Schmitt
D
D
Hetzer
R
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D000789:Angina, Unstable / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D002303:Cardiac Output, Low / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D002423:Cause of Death; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D011183:Postoperative Complications / Q000401:mortality* / Q000503:physiopathology; D011446:Prospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016277:Ventricular Function, Left / Q000502:physiology