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January 24, 1974New England Journal of Medicine156 citations

Aortocoronary Saphenous-Vein Bypass

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KHKarl E. HammermeisterJKJohn W. KennedyGHGlen W. Hamilton

Key Result

Saphenous-vein bypass grafting did not significantly change end-diastolic volume, end-systolic volume, or systolic ejection fraction compared to baseline, despite symptomatic improvement in 80%.

Study Design

Type

Observational (n=40)

Structured PICO

Does saphenous-vein bypass grafting improve resting ventricular performance in patients undergoing the procedure?

P
Population
40 patients undergoing saphenous-vein bypass grafting
I
Intervention
Saphenous-vein bypass grafting
C
Comparator
Pre-operative baseline (before and after surgery comparison)
O
Outcome
Resting ventricular performance (left ventricular volumes and ejection fraction)surrogate

Saphenous-vein bypass grafting improves symptoms and exercise performance but does not consistently improve resting left ventricular performance.

Abstract

To assess the effect of saphenous-vein bypass grafting on resting ventricular performance, left ventricular volumes and ejection fraction were measured before and after surgery in 40 patients. Symptomatic improvement occurred in 80 per cent (32 of 40), maximal treadmill exercise performance improved in 50 per cent (15 of 30) (p<0.05), and ischemic ST-segment response to exercise disappeared in 78 per cent (14 of 18). There were no significant changes in end-diastolic volume, end-systolic volume or systolic ejection fraction for the group as a whole after saphenous-vein bypass grafting or in subgroups with all patent grafts (28), no myocardial infarction (20) or total revascularization (18). Left ventricular contraction plots were unchanged after operation in 63 per cent (25 of 40), improved in 15 per cent (six of 40) and worse in 22 per cent (nine of 40). We conclude that saphenous-vein bypass grafting does not consistently improve left ventricular performance. (N Engl J Med 290:186–192, 1974)

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Cite This Study

Hammermeister et al. (1974) conducted an observational in Coronary artery disease requiring bypass (n=40). Saphenous-vein bypass grafting vs. Baseline (before surgery) was evaluated on Resting ventricular performance, left ventricular volumes and ejection fraction. Saphenous-vein bypass grafting did not significantly change end-diastolic volume, end-systolic volume, or systolic ejection fraction compared to baseline, despite symptomatic improvement in 80%.

synapsesocial.com/papers/6a0874e11e8b9db648de0cc2https://doi.org/10.1056/nejm197401242900403
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