PMID- 6604845
OWN - NLM
STAT- MEDLINE
DCOM- 19831123
LR  - 20061115
IS  - 0022-5223 (Print)
IS  - 0022-5223 (Linking)
VI  - 86
IP  - 4
DP  - 1983 Oct
TI  - Coronary artery bypass grafting in patients with ejection fractions below forty 
      percent. Early and late results in 466 patients.
PG  - 519-27
AB  - The outcome of patients undergoing coronary artery bypass grafting with 
      preoperative ejection fractions below 40% was evaluated to determine if a 
      specific level of ventricular dysfunction resulted in unacceptably poor 
      short-term or long-term survival rates. Left ventricular ejection fractions were 
      segregated into groups of five percentage points each starting from 35% to 39% 
      and progressing down to 10% to 14%. In evaluating the six ejection fraction 
      groups between 10% and 39%, we found no significant differences among them with 
      regard to previous myocardial infarctions, left ventricular end-diastolic 
      pressure (LVEDP), age, preoperative New York Heart Association (NYHA) class, or 
      number of vessels bypassed. Eighty-four percent were men and 16% women. From 1976 
      through 1982, 466 patients were distributed among these groups, all having 
      ejection fractions below 40% (mean 30% +/- 3% SEM). There were significant 
      differences (p = 0.001) in both the hospital and long-term survival (36 months) 
      of patients with preoperative ejection fractions from 20% to 39% (425 patients) 
      as compared to those with preoperative ejection fractions from 10% to 19% (41 
      patients). Hospital survival rate was 89% for patients with ejection fractions 
      from 20% to 39% but only 63% for patients with ejection fractions below 20%. 
      Similarly, at 3 years, patients with ejection fractions of 20% to 39% had an 
      average survival rate of 60% as compared to an average survival rate of 15% for 
      those with ejection fractions below 20%. Neither the preoperative LVEDP nor the 
      intraoperative ischemic arrest time significantly predicted survival. In all 
      survivors, NYHA class decreased from an average of 3.00 to 1.25 in surviving 
      patients following bypass at a mean follow-up of 29 +/- 5 months. It is concluded 
      that ejection fraction is an excellent predictor of short-term and long-term 
      survival following coronary artery bypass grafting. Patients with ejection 
      fractions of 10% to 19% have a significantly reduced short-term and long-term 
      survival rate as compared to patients with ejection fractions of 20% or more.
FAU - Hochberg, M S
AU  - Hochberg MS
FAU - Parsonnet, V
AU  - Parsonnet V
FAU - Gielchinsky, I
AU  - Gielchinsky I
FAU - Hussain, S M
AU  - Hussain SM
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Thorac Cardiovasc Surg
JT  - The Journal of thoracic and cardiovascular surgery
JID - 0376343
SB  - IM
MH  - Angina Pectoris/surgery
MH  - Angina, Unstable/surgery
MH  - *Cardiac Output
MH  - Coronary Artery Bypass/*mortality
MH  - Female
MH  - Heart Ventricles
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/surgery
MH  - Prognosis
MH  - Shock, Cardiogenic/surgery
MH  - *Stroke Volume
EDAT- 1983/10/01 00:00
MHDA- 1983/10/01 00:01
CRDT- 1983/10/01 00:00
PHST- 1983/10/01 00:00 [pubmed]
PHST- 1983/10/01 00:01 [medline]
PHST- 1983/10/01 00:00 [entrez]
PST - ppublish
SO  - J Thorac Cardiovasc Surg. 1983 Oct;86(4):519-27.