Key result
Preoperative IABP and advanced age independently predict cardiac death after CABG for severe LV dysfunction.
Cohort (n=102)
Coronary bypass surgery can yield satisfactory long-term survival in patients with severe left ventricular dysfunction, though obesity, advanced age, and the need for preoperative intra-aortic balloon counterpulsation are significant risk factors for mortality.
Preoperative IABP and advanced age flag higher cardiac mortality risk after CABG in severe LV dysfunction; hypothesis-generating for refined risk stratification.
The results of coronary bypass surgery have been assessed in 102 patients with severe left ventricular dysfunction who had a preoperative left ventricular ejection fraction of < or = 0.35 (mean (s.e.m.) 0.29 (0.01)). Independent risk factors influencing operative mortality were obesity (P = 0.0290) and the need for preoperative intra-aortic balloon counterpulsation (P = 0.0010). Cox regression analysis using as its end-point 'cardiac-related death' demonstrated three variables; the need for preoperative intra-aortic balloon counterpulsation (P < 0.001), advanced age (P = 0.011), and obesity (P = 0.36). In a subset of 43 patients who did not have these risk factors, the 4-year cardiac-related death rate was 95.1 (3.4)%. The operative mortality and long-term survival can be expected to be satisfactory in patients with severe left ventricular dysfunction, provided they have a viable myocardium rather than myocardial fibrosis.
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Yves Louagie (1996) conducted a cohort in Severe left ventricular dysfunction (n=102). Coronary bypass surgery was evaluated on Cardiac-related death. In patients undergoing coronary bypass surgery for severe left ventricular dysfunction, preoperative intra-aortic balloon counterpulsation (P<0.001) and advanced age (P=0.011) were independent risk factors for cardiac-related death.
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