title: Coronary artery bypass grafting in patients with left ventricular dysfunction.
abstract: BACKGROUND
  Coronary artery bypass grafting surgery (CABG) remains a challenge for patients with coronary artery disease and left ventricular (LV) dysfunction. The aim of this study was to evaluate the result of CABG in patients with LV dysfunction.
  
  
  METHODS
  Medical records of 1,847 patients who underwent primary, isolated CABG at Taipei Veterans General Hospital from January 1, 1991 to December 31, 2002, were reviewed. The mortality rate associated with clinical and operative variables was compared between patients with LV ejection fraction (LVEF) > or = 35% and patients with LVEF < 35%.
  
  
  RESULTS
  Patients with LVEF < 35% had more episodes of myocardial infarction (57.5% vs 28.9%, p < 0.001) and history of congestive heart failure (18.1% vs 3.2%, p < 0.001), higher New York Heart Association (NYHA) class, and higher angina class. Longer cardiopulmonary bypass time (147 +/- 44 minutes vs 137 +/- 40 minutes, p < 0.001) but fewer left internal mammary artery (LIMA) grafts (46.8% vs 65.7%, p < 0.001) were used in patients with LVEF < 35%. Patients with LVEF < 35% had significantly higher hospital mortality (6.6% vs 2.2%, p < 0.001), higher major morbidity (23.3% vs 16.1%, p < 0.01), and longer hospital stay (25 +/- 23 days vs 21 +/- 16 days, p < 0.01).
  
  
  CONCLUSIONS
  Although patients with LV dysfunction had higher mortality and morbidity, CABG could be done in these high-risk patients with acceptable results.
authors.affiliation: Division of Cardiovascular Surgery, Department of Surgery, National Yang-Ming University School of Medicine, and Taipei Veterans General Hospital, Taiwan, ROC.
authors.forename: Fei-Yi
authors.initials: FY
authors.lastname: Wu
authors.forename: Yen-Chou
authors.initials: YC
authors.lastname: Lu
authors.forename: Shiau-Ting
authors.initials: ST
authors.lastname: Lai
authors.forename: Zen-Chung
authors.initials: ZC
authors.lastname: Weng
authors.forename: Cheng-Hsiung
authors.initials: CH
authors.lastname: Huang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D016277:Ventricular Function, Left