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Coronary Artery Bypass in Patients With Severe Left Ventricular Dysfunction

Department of Cardiovascular and Thoracic Surgery 1 Department of Cardiology Sri Venkateswara Institute of Medical Sciences Tirupati, Andhra Pradesh, India
For reprint information contact: Dronamraju Dilip, FRCS Tel: 91 8574 87777 Fax: 91 8574 86803 email: drdilip_d{at}yahoo.com Department of Cardiovascular and Thoracic Surgery, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh 517507, India.

We retrospectively reviewed the case records of 82 patients with severe left ventricular dysfunction (ejection fraction < 30%) who underwent coronary artery bypass grafting between March 1993 and February 2000. They were aged 28 to 76 years (mean, 60 years), and 66 of them were male. Significant comorbid factors included hypertension (93%), diabetes mellitus (85%), and hypercholesterolemia (49%). The number of grafts used ranged from 1 to 3. The majority of the patients (91%) belonged to the Canadian Cardiovascular Society angina class III. Coronary angiography revealed single-vessel (in 16% of the patients), double-vessel (52%), and triple-vessel disease (32%), and left main stem disease (18%). Seven patients (9%) died within 48 hours after surgery. The mean duration of hospital stay was 7 ± 2 days. The 75 patients who survived were followed up for 3 months to 7 years. At the 1-year follow-up, 61 of the 68 patients (90%) who were alive moved up from angina class III to class I. Our observations suggest that coronary bypass carries an acceptable mortality risk and may offer a better quality of life in patients with poor ventricular function.