PMID- 9546848
OWN - NLM
STAT- MEDLINE
DCOM- 19980410
LR  - 20191024
IS  - 0967-2109 (Print)
IS  - 0967-2109 (Linking)
VI  - 6
IP  - 1
DP  - 1998 Feb
TI  - Predicting outcome after myocardial revascularization in patients with left 
      ventricular dysfunction.
PG  - 58-66
AB  - In order to identify the risk factors which could predict outcome after coronary 
      artery bypass grafting in patients with left ventricular dysfunction, 80 
      consecutive patients with an ejection fraction < or = 30%, who underwent isolated 
      coronary artery bypass grafting at the authors' centre between January 1994 and 
      May 1996 were evaluated. Preoperatively, mean(s.d.) ejection fraction was 
      27.1(3.8)%, 56 patients (70%) had angina, and 56(70%) were in New York Heart 
      Association (NYHA) functional class III or IV. There were five operative deaths, 
      with a hospital mortality rate of 6.3%. Significant risk factors for hospital 
      death were NYHA class IV, preoperative ventricular arrhythmias and left 
      ventricular end-diastolic volume index > 110 ml/m2. At mean follow-up of 15(7) 
      (range 6-30) months, there were six late deaths, five of which were from cardiac 
      causes. Actuarial survival rate at 2 years was 82(5)% and freedom from cardiac 
      death 84(5)%. Risk factors for overall mortality from cardiac causes were 
      preoperative grade 2 mitral regurgitation, associated with left ventricular 
      dilatation, and renal dysfunction (creatininaemia > or = 180 micromol/l). At 
      follow-up, mean ejection fraction was 37.5(8.4)%, and the overall functional 
      status had improved: 12 patients (18%) had angina and eight (12%) were in NYHA 
      class III and IV. Myocardial revascularization in patients with left ventricular 
      dysfunction can be performed with acceptably low operative risk, good survival 
      rate at 2 years, and functional status improvement. Patients with extensive 
      ventricular dilatation, associated with significant mitral regurgitation, have a 
      lower life expectancy and less functional benefits from coronary artery bypass 
      grafting. These patients are better treated by cardiac transplantation.
FAU - De Carlo, M
AU  - De Carlo M
AD  - Department of Cardiac Surgery, University of Pisa, Italy.
FAU - Milano, A
AU  - Milano A
FAU - Borzoni, G
AU  - Borzoni G
FAU - Pratali, S
AU  - Pratali S
FAU - Barzaghi, C
AU  - Barzaghi C
FAU - Tartarini, G
AU  - Tartarini G
FAU - Mariani, M
AU  - Mariani M
FAU - Bortolotti, U
AU  - Bortolotti U
LA  - eng
PT  - Journal Article
PL  - England
TA  - Cardiovasc Surg
JT  - Cardiovascular surgery (London, England)
JID - 9308765
SB  - IM
MH  - Aged
MH  - *Coronary Artery Bypass/mortality
MH  - Coronary Disease/mortality/*surgery
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Stroke Volume/physiology
MH  - Survival Analysis
MH  - Survival Rate
MH  - Time Factors
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Left/mortality/*surgery
EDAT- 1998/04/18 00:00
MHDA- 1998/04/18 00:01
CRDT- 1998/04/18 00:00
PHST- 1998/04/18 00:00 [pubmed]
PHST- 1998/04/18 00:01 [medline]
PHST- 1998/04/18 00:00 [entrez]
AID - S0967210997000811 [pii]
AID - 10.1016/s0967-2109(97)00081-1 [doi]
PST - ppublish
SO  - Cardiovasc Surg. 1998 Feb;6(1):58-66. doi: 10.1016/s0967-2109(97)00081-1.