PMID- 7721925
OWN - NLM
STAT- MEDLINE
DCOM- 19950525
LR  - 20161026
IS  - 0021-9509 (Print)
IS  - 0021-9509 (Linking)
VI  - 36
IP  - 1
DP  - 1995 Feb
TI  - Effect of low left ventricular ejection fractions on the outcome of primary 
      coronary by-pass grafting in end-stage coronary artery disease.
PG  - 45-51
AB  - Advanced ischemic heart disease (HID) with very low left ventricular ejection 
      fraction (LVEF), pulmonary hypertension (PHT) with or/without left ventricular 
      aneurysm (LVA) are criteria for defining end-stage coronary artery disease 
      (ESCAD). Coronary artery by-pass grafting is often denied to these patients. 
      Between January 1990 and December 1993, 91 patients with ESCAD, significant 2 or 
      3-vessel disease (stenosis > or = 70%) and LVEF < or = 25% underwent primary CABG 
      at our institutions. The mean age was 62.5 +/- 8.0 years (41-81), 89% were men. 
      Eighty-one patients were in preoperative NYHA (New York Heart Association) 
      functional class 3 and 4. Mean LVEF was 21.3 +/- 3.8% (10-25). Mitral 
      regurgitation (MR) was present in 39/91 (43%). The systolic pulmonary artery 
      pressure (PAP) was 33.2 +/- 17.1 mmHg (11-75) and the wedge pressure was 19.0 +/- 
      10.8 mmHg (5-47). Twenty-two patients had significant PHT with a systolic PAP > 
      or = 40 mmHg. The overall perioperative mortality was 14.3% (13/91). Low 
      postoperative cardiac output occurred in 33 patients, requiring intraaortic 
      balloon support in 13. Gastrointestinal complications occurred in 6 patients and 
      neurological events in one. Fifteen patients had additional left ventricular 
      aneurysm repair. There was a good correlation between LVEF and PAP (r = 0.782). 
      Surprisingly, in a subset of patients with preoperative PHT and LVEF < or = 25% 
      the mortality rate was only 4.6% (1/22). Other perioperative complications did 
      not differ.(ABSTRACT TRUNCATED AT 250 WORDS)
FAU - Christenson, J T
AU  - Christenson JT
AD  - Cardiovascular Surgery Unit, Hopital de la Tour, Meyrin-Geneva, Switzerland.
FAU - Maurice, J
AU  - Maurice J
FAU - Simonet, F
AU  - Simonet F
FAU - Bloch, A
AU  - Bloch A
FAU - Fournet, P C
AU  - Fournet PC
FAU - Velebit, V
AU  - Velebit V
FAU - Schmuziger, M
AU  - Schmuziger M
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - Italy
TA  - J Cardiovasc Surg (Torino)
JT  - The Journal of cardiovascular surgery
JID - 0066127
SB  - IM
MH  - Aged
MH  - Chi-Square Distribution
MH  - *Coronary Artery Bypass/methods/mortality
MH  - Coronary Disease/mortality/*physiopathology/*surgery
MH  - Female
MH  - Hospital Mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications/epidemiology
MH  - *Stroke Volume
MH  - Switzerland/epidemiology
MH  - Treatment Outcome
MH  - *Ventricular Function, Left
EDAT- 1995/02/01 00:00
MHDA- 1995/02/01 00:01
CRDT- 1995/02/01 00:00
PHST- 1995/02/01 00:00 [pubmed]
PHST- 1995/02/01 00:01 [medline]
PHST- 1995/02/01 00:00 [entrez]
PST - ppublish
SO  - J Cardiovasc Surg (Torino). 1995 Feb;36(1):45-51.