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  • Title: [Retrospective assessment of influence of pre-and intra-operative risk factors on early and late surgical results in patients with coronary heart disease and severly impaired left ventricle function who underwent coronary artery bypass grafting].
    Author: Janas R, Gburek T, Cisowski M, Wilczyński M, Białkowska B, Bochenek A.
    Journal: Wiad Lek; 2004; 57(9-10):413-20. PubMed ID: 15765754.
    Abstract:
    Aim of the study was to evaluate retrospectively recent and late results of coronary artery bypass grafting (CABG) in patients with ischaemic heart disease and severe left ventricular dysfunction. 146 patients (125 men, 21 women) aged 58.4 +/- 8.4 years, with angina (Canadian Cardiac Society--CCS class > or = 1), heart failure (New York Heart Association--NYHA class > or = 1), left ventricular ejection fraction (LVEF < or = 30%), multi-vessel coronary disease were included to the study. All patients underwent CABG. Peri-operative mortality was 6.1%, in-hospital mortality was 8.2%, 1-year survival was 86.5% and 4-year survival--80%. It was shown that CABG improves angina, dyspnoea and LVEF in patients with coronary heart disease and depressed left ventricle function (LVEF < or = 30%). Selected parameters like: unstable angina requiring intra-aortic balloon pump (IABP) preoperatively, recent heart infarction, cerebrovascular disease, severly depressed left ventricle function (LVEF < or = 20%), mitral regurgitation and Cleveland score > or = 10 pts significantly influence early surgical results (up to 30 days after surgery). It was shown that independent parameters predicting long-term survival and risk of major cardiac events were: negative dobutamine stress test, significant mitral valve incompetence and Cleveland score > or = 10 pts. Use of crystalloid cardioplegia increases early risk of CABG however none of methods of myocardial protection affects long-term surgical results. The outcomes of procedures using blood cardioplegia or intermittent cross clamp and ventricular fibrillation are comparable.
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