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Type: Journal article
Title: Prediction of outcome after revascularization in patients with poor left ventricular function
Author: Chan, R.
Raman, J.
Lee, K.
Rosalion, A.
Hicks, R.
Pornvilawan, S.
Sia, B.
Horowitz, J.
Tonkin, A.
Buxton, B.
Citation: Annals of Thoracic Surgery, 1996; 61(5):1428-1434
Publisher: Elsevier
Issue Date: 1996
ISSN: 0003-4975
Statement of
Robert K. M. Chan, Jai Raman, Kenneth J. Lee, Alexander Rosalion, Rodney J. Hicks, Sampanth Pornvilawan, Benjamin S. T. Sia, John D. Horowitz, Andrew M. Tonkin and Brian F. Buxton
Abstract: Background. In patients with poor left ventricular function, the determinants of outcome after revascularization are unknown. Methods. We studied prospectively 57 patients with stable coronary artery disease and poor left ventricular function (left ventricular ejection fraction 0.28 ± 0.04) who underwent coronary artery bypass grafting. Clinical variables were assessed as predictors of outcome in all patients, and peoperative stress thallium-201 scintigraphic data were analysed in 37 patients. Results. The operative mortality was 1.7%. At 12 months after operation, 46 of the 49 survivors were angina-free and 35 had fewer heart failure symptoms, but postoperative left ventricular ejection fraction (0.30 ± 0.09) did not change significantly. Eighteen survivors had left ventricular ejection fraction improved by 0.05 or more (0.30 ± 0.03 preoperatively, 0.40 ± 0.05 postopertively; p = 0.0001). The adjusted odds ratio of large reversible thallium-201 defects in predicting such outcome was 15 (95% confidence interval, 1.6 to 140), whereas othe clinical variables had no predictive value. The transplantation-free 5-year survival was 73%. Conclusions. In patients with poor left ventricular function, surgical revascularization can be performed safely, with good symptomatic relief and long-term survival. One-year survival and improvement in left ventricular function is better in patients with large reversible defects on preoperative stress thallium-201 scintigraphy.
Keywords: Humans
Coronary Disease
Ventricular Dysfunction, Left
Thallium Radioisotopes
Radionuclide Ventriculography
Treatment Failure
Coronary Artery Bypass
Prospective Studies
Predictive Value of Tests
Middle Aged
Description: © 1996 by The Society of Thoracic Surgeons
DOI: 10.1016/0003-4975(96)00089-6
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