Effect of coronary artery bypass surgery on ventricular functions in patients with poor left ventricular function

Year 2019, , 502 - 509, 04.05.2019

Cüneyd Öztürk , Şenol Yavuz

https://doi.org/10.18621/eurj.519917

Cited By: 4

Abstract

Objectives: The
aim of the present study was to compare preoperative / postoperative
ventricular functions of patients with ventricular dysfunction who were planned
for coronary artery bypass grafting (CABG) using echocardiography and
angiography, and to evaluate whether there was a significant improvement in
ventricular function.

Methods: This
prospective study included 30 patients with poor ventricular function who had
undergone CABG at the Cardiovascular Surgery Clinics of Bursa Yüksek Ihtisas
Hospital. The patients' ventricular functions were compared preoperatively and
postoperatively at the 2^nd, 6^th and 12^th
months.

Results: Of
the patients, 28 were males, and the mean age was 60.1 ± 8 years (range 39-71).
In these cases, functional capacity improved within the early postoperative
period, and global ventricular functions improved within the postoperative
first year. The improvement in ejection fraction results was statistically
significant at 6 months and 12 months (p
< 0.05). A significant decrease was observed in left ventricular
enddiastolic pressures within one year (p
< 0.001). For the performance score, improvement was significant from the 2^nd
month (p < 0.05).

Conclusions:
Our findings show that CABG improves ventricular function in terms
of EF, PS, LVEDP and NYHA classification. In conclusion, we consider that CABG
is a significantly effective option in patients with poor ventricular function. 

Keywords

Coronary artery bypass grafting, poor left ventricular function, ischemic heart disease

References

• [1] Ahmadi A, Stone GW, Leipsic J, Shaw LJ, Villines TC, Kern MJ, et al. Prognostic determinants of coronary atherosclerosis in stable ischemic heart disease: anatomy, physiology, or morphology? Circ Res 2016;119:317-29.
• [2] Denktas AE, Paniagua D, Jneid H. Coronary physiology assessment for the diagnosis and treatment of stable ischemic heart disease. Curr Atheroscler Rep 2016;18:62.
• [3] Koene RJ, Kealhofer JV, Adabag S, Vakil K, Florea VG. Effect of coronary artery bypass graft surgery on left ventricular systolic function. J Thorac Dis 2017;9:262-70.
• [4] Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE Jr, Drazner MH, et al; American College of Cardiology Foundation; American Heart Association Task Force on Practice Guidelines. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2013;62:e147-239.
• [5] Kim MS, Lee JH, Cho HJ, Cho JY, Choi JO, Hwang KK, et al. KSHF Guidelines for the Management of Acute Heart Failure: Part III. Specific management of acute heart failure according to the etiology and co-morbidity. Korean Circ J 2019;49:46-68.
• [6] Velazquez EJ, Bonow RO. Revascularization in severe left ventricular dysfunction. J Am Coll Cardiol 2015:17;65:615-24.
• [7] Nizamic T, Murad MH, Allen LA, McIlvennan CK, Wordingham SE, Matlock DD, et al. Ambulatory inotrope infusions in advanced heart failure: a systematic review and meta-analysis. JACC Heart Fail 2018;6:757-67.
• [8] Sobolev BG, Fradet G, Hayden R, Kuramoto L, Levy AR, Fitzgerald MJ. Survival benefit of coronary-artery bypass grafting accounted for deaths in those who remained untreated. J Cardiothorac Surg 2008;3:47.
• [9] Hung J, Kelly DT, Baird DK, Hendel PN, Leckie BD, Grant AF, et al. Aorta-coronary bypass grafting in patients with severe left ventricular dysfunction. J Thorac Cardiovasc Surg 1980;79:718-23.
• [10] Mundth ED, Harthorne JW, Buckley MJ, Dinsmore R, Austen WG: Direct coronary arterial revascularization. Treatment of cardiac failure associated with coronary artery disease. Arch Surg 1971;103:529-34.
• [11] Pepper J. Managing heart failure patients with multivessel disease--Coronary Artery Bypass Graft versus Percutaneous Coronary Intervention. Card Fail Rev 2015;1:118-22.
• [12] Inamdar AA, Inamdar AC. Heart failure: diagnosis, management and utilization. J Clin Med 2016;5:62.
• [13] Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF. Braunwald's Heart Disease E-Book: A Textbook of Cardiovascular Medicine. International edition, 11th ed, Elsevier, 2018.
• [14] Makkar RR, Smith RR, Cheng K, Malliaras K, Thomson LE, Berman D, et al. Intracoronary cardiosphere-derived cells for heart regeneration after myocardial infarction (CADUCEUS): A prospective, randomised phase 1 trial. Lancet 2012;379:895-904.
• [15] Kron IL, Flanagan TL, Blackbourne LH, Schroeder RA, Nolan SP. Coronary revascularization rather than cardiac transplantation for chronic ischemic cardiomyopathy. Ann Surg 1989;210:348-54.
• [16] Louie HW, Laks H, Milgalter E, Drinkwater DC Jr, Hamilton MA, Brunken RC, et al. Ischemic cardiomyopathy. Criteria for coronary revascularization and cardiac transplantation. Circulation 1991;84:290-5.
• [17] Mintz LJ, Ingels NB, Daughters GT, Stinson EB, Alderman EL. Sequential studies of left ventricular function and wall motion after coronary arterial bypass surgery. Am J Cardiol 1980,45:210-6.
• [18] Christakis GT, Weisel RD, Fremes SE, Ivanov J, David TE, Goldman BS, et al. Coronary artery bypass grafting in patients with poor ventricular function. Cardiovascular Surgeons of the University of Toronto. J Thorac Cardiovasc Surg 1992;103:1083-92.
• [19] Kloner RA, Przyklenk K, Kay GL. Clinical evidence for stunned myocardium after coronary artery bypass surgery. J Card Surg 1994;9:397-402.
• [20] Hillis LD, Smith PK, Anderson JL, Bittl JA, Bridges CR, Byrne JG, et al. 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 2011;124:2610-42.
• [21] Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, et al. ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. Circulation 2011;124:2574-609.