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Coronary Artery Bypass Grafting in Patients with Chronic Congestive Heart Failure: A 10‐Year Experience with 203 Patients
Author(s) -
Anderson William A.,
Ilkowski Deborah A.,
Mahan Vicki L.,
Anolik Gail,
Fernandez Javier,
Laub Glenn W.,
Chen Chao,
McGrath Lynn B.
Publication year - 1997
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/j.1540-8191.1997.tb00118.x
Subject(s) - medicine , bypass grafting , heart failure , artery , cardiology , surgery
A bstract From 1983 to 1992, 203 patients with chronic congestive heart failure and no angina underwent primary coronary artery bypass. This represented 3% of patients undergoing coronary artery bypass grafting. Ninety‐two percent of the patients were in New York Heart Association (NYHA) functional class III or IV prior to undergoing coronary artery bypass grafting. Thallium perfusion imaging was performed in 21% of the patients, with a reversible defect present in 88%. An internal mammary artery graft was used in 70% of the patients. The hospital mortality was 6.0% and the actuarial survival at 5 years was 59%. An improvement in NYHA functional class occurred in 75% of the surviving patients with a mean improvement of 1.6 ± 0.6 functional classes. Univariate analysis identifed risk factors for hospital death as emergency operation, recent myocardial infarction (< 30 days), and the need for an intra‐aortic balloon pump. A trend emerged for nonuse of an internal mammary artery to predict hospital death. A positive thallium perfusion scan was not a predictor of early or late survival, nor did it influence NYHA functional class. The use of the internal mammary artery signifcantly enhanced late survival (p = 0.01), however, did not affect the functional class of survivors. We conclude that coronary artery bypass grafting is effective in ameliorating symptoms of chronic congestive heart failure in patients suffering from chronic ischemic cardiomyopathy and can be performed with acceptabie early and late mortality.