title: Results of coronary artery bypass grafting alone and combined with surgical ventricular reconstruction for ischemic heart failure.
abstract: In this study, we included 236 patients with ischemic heart failure and ejection fraction (EF) <35% who underwent surgical treatment. Patients were randomized in two groups. There were 116 patients who underwent coronary artery bypass grafting (CABG) with surgical ventricular reconstruction (SVR) and 120 patients who underwent CABG alone. The hospital mortality rate was 5.8% after isolated CABG and 3.5% after CABG combined with SVR. All survivors had follow-up investigation from four months to five years, with a mean follow-up time of 31±13 months. The mean New York Heart Association (NYHA) functional class decreased from 2.9±0.5 to 2.2±0.7 one year after CABG and from 3.1±0.4 to 2.0±0.6 one year after CABG with SVR. We showed that left ventricular reconstruction significantly decreased EDV from 237±52 to 176±30 and correspondingly increased EF from 32±6 to 39±9. However, after isolated CABG EF did not increase significantly (32±7 preoperatively and 34±11 postoperatively). One- and three-year rates were 95% and 78% after SVR with CABG and 83% and 78% after CABG alone. Despite the more aggressive surgical strategy, left ventricular reconstruction did not increase operative mortality and early results were significantly effective compared with coronary artery bypass grafting alone.
authors.affiliation: Department of Aortic and Coronary Artery Surgery, Research Institute of Circulation Pathology, Novosibirsk, Russia. mammaria@mail.ru
authors.forename: Andrey
authors.initials: A
authors.lastname: Marchenko
authors.forename: Alexander
authors.initials: A
authors.lastname: Chernyavsky
authors.forename: Vidady
authors.initials: V
authors.lastname: Efendiev
authors.forename: Tanya
authors.initials: T
authors.lastname: Volokitina
authors.forename: Alexander
authors.initials: A
authors.lastname: Karaskov
mesh_terms: D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D016009:Chi-Square Distribution; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D006352:Heart Ventricles / Q000503:physiopathology / Q000601:surgery; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D020127:Recovery of Function; D018570:Risk Assessment; D012307:Risk Factors; D012426:Russia; D013318:Stroke Volume; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D016277:Ventricular Function, Left