Coronary Artery Bypass Grafting iin Severe Left Veni-vicular Dysfunction : Excellent Survival With Improved Ejection Fraction and Functional Staltle

Objectives. The present study evaluated our experience with coronary artery bypass grafting in patients with severe left ventricular dysfunction. Background. Despite the ominous prognosis of advanced ischemic cardiomyopathy, coronary artery bypass grafting in this setting remains controversial because of concerns over operative risk and lack of functional or survival benefit . Methods. We analyzed the data of 83 consecutive patients (69 men, 14 women, aged 42 to 83 years [mean 66 .8]) with a left ventricular ejection fraction !530% who underwent isolated coronary artery bypass grafting (without aneurysmectomy, valve replacement or other open heart procedures) performed by one surgeon during a 6-year period . The ejection fraction ranged from 10% to 30% (mean 24 .6%). Preoperatively, 49% of patients had angina, 52% had congestive heart failure (17% with pulmonary edema) and 30% manifested significant ventricular arrhythmia . The mean number of grafts was 2.7/patient. The internal mammary artery was used in 82% of grafts to the left anterior descending coronary artery . The intraaortic balloon pump was required therapeutically (for angina or pump failure) in 19% of patients and was prophylactically placed preoperatively in another 43% of patients.