The Journal of Thoracic and Cardiovascular Surgery, Vol 70, 1064-1072, Copyright © 1975 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Long-term functional results of surgery for coronary artery disease in patients with poor ventricular function
HE Fox, IA May and RR Ecker
Thirty-two patients with coronary artery disease and an ejection fraction
(EF) below 0.40 had coronary bypass and/or left ventricular aneurysm (LVA)
resection. Twenty-four patients had a previous infarction, 12 had
congestive heart failure (CHF), and left ventricular end-diastolic pressure
averaged 15 mm. Hg. Nineteen patients had three- vessel involvement and
there was an average of 2.4 vessels involved per patient. Bypass was
accomplished on 87 per cent of vessels; 11 patients had resection of LVA;
11 had coronary endarterectomy. There were no hospital deaths, 63 per cent
of the patients were improved, and 56 per cent were able to return to work
or full activity. There were five late deaths (16 per cent). There was good
functional improvement in 83 per cent of the survivors, followed 1 to 4
years. We believe that patients with poor ventricular function due to
severe coronary artery disease should not categorically be denied surgery,
and that operation can be done with a low hospital mortality rate and good
functional results.
