title: Low ejection fraction predicts shortened survival in patients undergoing infrainguinal arterial reconstruction.
abstract: BACKGROUND
  With the advent of endovascular therapy for lower extremity ischemia it is important to better determine what factors may affect the outcome. The goal of the present study was to evaluate whether ejection fraction (EF) is predictive of outcome in infrainguinal arterial reconstruction.
  
  
  METHODS
  We retrospectively reviewed 736 patients undergoing 897 infrainguinal arterial reconstructions from July 1999 to February 2002. Patients were divided into two groups: group I contained 54 patients with an EF<35% and group II had 216 patients with an EF > or =35%. The outcome evaluated was major adverse clinical events (MACEs), defined as postoperative myocardial infarction (MI), arrhythmia, congestive heart failure (CHF), and perioperative mortality.
  
  
  RESULTS
  Major adverse clinical events occurred in 20.3% of patients (11/54) in group I and 10.6% patients (23/216) in group II (p = 0.068). Group I had a trend toward a greater incidence of MACEs compared to group II. Two-year survival for group I was 61.7%, whereas survival for group II was 78.4% (p = 0.0085).
  
  
  CONCLUSIONS
  Low EF predicts a significantly shortened 2-year survival after infrainguinal arterial reconstruction and a trend toward increased perioperative complications. This is another factor to be considered in choosing open versus endovascular options.
authors.affiliation: Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA. gshrikha@caregroup.harvard.edu
authors.forename: Gautam V
authors.initials: GV
authors.lastname: Shrikhande
authors.forename: Allen D
authors.initials: AD
authors.lastname: Hamdan
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Monahan
authors.forename: Frank B
authors.initials: FB
authors.lastname: Pomposelli
authors.forename: Sherry D
authors.initials: SD
authors.lastname: Scovell
authors.forename: Frank W
authors.initials: FW
authors.lastname: Logerfo
authors.forename: Marc
authors.initials: M
authors.lastname: Schermerhorn
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries / Q000601:surgery*; D000075202:Contraindications; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D053208:Kaplan-Meier Estimate; D035002:Lower Extremity / Q000098:blood supply* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000601:surgery; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D013318:Stroke Volume; D014656:Vascular Surgical Procedures / Q000706:statistics & numerical data