PMID- 12757335
OWN - NLM
STAT- MEDLINE
DCOM- 20030910
LR  - 20190922
IS  - 0886-0440 (Print)
IS  - 0886-0440 (Linking)
VI  - 18
IP  - 2
DP  - 2003 Mar-Apr
TI  - Predictors of early outcome after coronary artery surgery in patients with severe 
      left ventricular dysfunction.
PG  - 101-6
AB  - BACKGROUND: The surgical survival in patients with severe myocardial dysfunction 
      is critically dependent on the selection of patients. The present study was 
      undertaken to identify the prognostic factors in such patients. METHODS: We 
      analyzed the data of 176 consecutive patients (161 men, 15 women), aged 29 to 88 
      years (mean 58.43), with a left ventricular ejection fraction (LVEF) < 30% who 
      underwent isolated coronary artery bypass grafting. The LVEF ranged from 15% to 
      30% (mean 27.18%). Preoperatively, 33% had angina, 19.9% had recent myocardial 
      infarction, and 21.6% had congestive heart failure. The mean number of grafts was 
      2.5/patient. The intra-aortic balloon was used prophylactically in 20.5% of 
      patients and therapeutically in 4.0% of patients. RESULTS: The hospital mortality 
      was 2.3%. The complications occurred as follows: perioperative myocardial 
      infarction in two (1.1%), intractable ventricular arrhythmias in two (1.1%), 
      prolonged ventilation in four (2.3%) and peritoneal dialysis in 1 (0.6%). The 
      mean ICU and hospital stay were 2.46 +/- 0.76 and 7.57 +/- 2.24 days, 
      respectively. The predictors of survival on univariate analysis were New York 
      Heart Association (NYHA) class (x2 = 14.458, p < 0.001), recent myocardial 
      infarction (x2 = 5.852, p = 0.016), congestive heart failure (CHF) (x2 = 5.526, p 
      = 0.019), and left ventricular end-systolic volume index (LVESVI) (x2 = 25.833, p 
      < 0.001). However, on multivariate analysis, left ventricular end-systolic volume 
      index was the only independent left ventricular function measurement predictive 
      of survival (x2 = 10.228, p = 0.001). CONCLUSION: Left ventricular end-systolic 
      volume index is the most important predictor of survival after coronary artery 
      bypass surgery in patients with severe myocardial dysfunction.
FAU - Trehan, Naresh
AU  - Trehan N
AD  - Escorts Heart Institute and Research Centre, Okhla Road, New Delhi 110025, India.
FAU - Khanna, Surendra Nath
AU  - Khanna SN
FAU - Mishra, Yugal
AU  - Mishra Y
FAU - Kohli, Vijay
AU  - Kohli V
FAU - Mehta, Yatin
AU  - Mehta Y
FAU - Mishra, Manisha
AU  - Mishra M
FAU - Mittal, Sanjay
AU  - Mittal S
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Card Surg
JT  - Journal of cardiac surgery
JID - 8908809
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - *Cause of Death
MH  - Cohort Studies
MH  - Comorbidity
MH  - Coronary Artery Bypass/methods/*mortality
MH  - Coronary Artery Disease/*epidemiology/*surgery
MH  - Female
MH  - Heart Function Tests
MH  - Hemodynamics/physiology
MH  - Humans
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications/mortality
MH  - Postoperative Period
MH  - Predictive Value of Tests
MH  - Probability
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Severity of Illness Index
MH  - Survival Analysis
MH  - Time Factors
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Left/diagnosis/*epidemiology
EDAT- 2003/05/22 05:00
MHDA- 2003/09/11 05:00
CRDT- 2003/05/22 05:00
PHST- 2003/05/22 05:00 [pubmed]
PHST- 2003/09/11 05:00 [medline]
PHST- 2003/05/22 05:00 [entrez]
AID - 10.1046/j.1540-8191.2003.02011.x [doi]
PST - ppublish
SO  - J Card Surg. 2003 Mar-Apr;18(2):101-6. doi: 10.1046/j.1540-8191.2003.02011.x.