Coronary Artery Bypass Grafting in Patients with Poor Left Venfricular Function.
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概要
- 論文の詳細を見る
Coronary artery bypass grafting (CABG) in patients with poor left ventricular function remains a surgical challenge and is still controversial. The purposes of this study were to evaluate the effectiveness of CABG in such patients when performed without case selection on the basis of preoperative viability tests and to determine the predictors of postperative outcome. The preoperative, perioperative, and postoperative early and mid-term follow-up data of 273 patients with ≤30% left ventricular ejection fraction (LVEF) who underwent isolated CABG between January 1995 and November 2000 were evaluated. Preoperative echocardiography and cardiac catheterization, and postoperative control echocardiography were performed in all patients. Follow-up was achieved via monthly periodical examinations in the first 6 months, and thereafter by either regular visits or phone contact. Preoperatively, 242 (88.65%) patients were in NYHA class III or IV, and the mean LVEF was 26.51±3.64%. The overall hospital mortality total was 14 (5.13%) patients. There were 44 (16.12%) late mortalities. Postoperative morbidities were observed in 74 (27.1%) patients. Two-hundred and two (93.95%) of the surviving 215 (78.75%) patients were in NYHA class I or II at 49.55±14.84 months of follow-up. Postoperative follow-up echocardiographic examinations revealed a mean LVEF of 39.66%±5.43%. The improvements in functional capacity and LVEF were significant. Advanced age, diabetes, hypertension, cross-clamp time >60 min, bypass time>120 min, and severity of functional class (class III-IV of NYHA) were found to be the determinants of mortality. However, multivariate analyses revealed only older age and class III-IV of NYHA and CCS were predictors of mortality. The low mortality and morbidity rates as well as satisfactory postoperative improvements in functional capacity and LVEF measurements support the use of CABG without the need for any viability assessment in patients with left ventricular dysfunction.
- International Heart Journal刊行会の論文
著者
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Ozbaran Mustafa
Department Of Cardiac Surgery Ege University Medical Faculty
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POSACIOGLU Hakan
Department of Cardiovascular Surgery, Ege University Medical School
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Apaydin Anil
Department Of Cardiovascular Surgery Ege University Medical School
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Islamoglu Fatih
Department Of Cardiovascular Surgery Ege University Medical School
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Buket Suat
Department Of Cardiovascular Surgery Ege University Medical School
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Apaydin Anil
Department of Cardiovascular Surgery, Ege University Medical Faculty
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Hamulu Ahmet
Department of Cardiovascular Surgery, Ege University Medical Faculty
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Telli Ali
Department of Cardiovascular Surgery, Ege University Medical Faculty
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Durmaz Isa
Department of Cardiovascular Surgery, Ege University Medical Faculty
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Posacioglu Hakan
Department of Cardiovascular Surgery, Ege University Medical Faculty
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