Coronary revascularization in ischemic cardiomyopathy.
This article first discusses coronary artery disease, including left-ventricular dysfunction, hibernating myocardium, the relationship between stunning, hibernation, and heart failure, and molecular mechanisms underlying myocardial hibernation. Left ventricular function and the prognosis and pathophysiology of left-ventricular dysfunction are then examined. Selection of patients for revascularization is discussed, to include which coronary patients should be investigated for myocardial viability, and other surgical considerations are outlined. The outcome following revascularization in the heart failure patient, the results of revascularization, and the time course of functional recovery after coronary artery bypass graft are also covered.
Westaby
Stephen
S
Department of Cardiac Surgery, Oxford Heart Centre, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU, UK. swestaby@ahf.org.uk
D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D001026:Coronary Artery Bypass / Q000379:methods; D003327:Coronary Disease / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D009204:Myocardial Revascularization / Q000379:methods*; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D016019:Survival Analysis; D016896:Treatment Outcome