Evaluation of Postoperative Cardiac Function in Severe Ischemic Heart Disease Associated with Decreased Ejection Fraction
This clinical study was peformed to clarify the postoperative cardiac functions after coronary artery bypass graft surgery in the cases associated with decreased left ventricular ejection fraction (EF) or increased end-diastolic volume index (EDVI). The patients were divided into two groups by preop...
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| Published in | Japanese Journal of Cardiovascular Surgery Vol. 26; no. 5; pp. 285 - 292 |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
The Japanese Society for Cardiovascular Surgery
1997
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0285-1474 1883-4108 |
| DOI | 10.4326/jjcvs.26.285 |
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| Abstract | This clinical study was peformed to clarify the postoperative cardiac functions after coronary artery bypass graft surgery in the cases associated with decreased left ventricular ejection fraction (EF) or increased end-diastolic volume index (EDVI). The patients were divided into two groups by preoperative EF. The EF of Group I ranged from 31 to 39% in 42 cases, and the EF of Group II was below 30% in 27 cases. Several parameters of cardiac function such as EF, peak ejection rate (PER), peak filling rate (PFR) or early diastolic peak filling rate were evaluated with radionuclide ventriculography. Postoperative mean values of these parameters significantly improved in both Group I and Group II compared to preoperative values. Although these parameters and left ventricular wall motion did not improve in the 7 cases with an EDVI over 140ml/m2 in Group II, the clinical results of these 7 cases were good during the follow-up period except one case which preoperatively had frequent ventricular arrythmia. The clinical condition improved remarkably in the 3 patients who had preoperative angina pectoris among these 7 cases. Surgical indications must be carefully determined in cases with increased EDVI and frequent ventricular arrythmia. |
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| AbstractList | This clinical study was peformed to clarify the postoperative cardiac functions after coronary artery bypass graft surgery in the cases associated with decreased left ventricular ejection fraction (EF) or increased end-diastolic volume index (EDVI). The patients were divided into two groups by preoperative EF. The EF of Group I ranged from 31 to 39% in 42 cases, and the EF of Group II was below 30% in 27 cases. Several parameters of cardiac function such as EF, peak ejection rate (PER), peak filling rate (PFR) or early diastolic peak filling rate were evaluated with radionuclide ventriculography. Postoperative mean values of these parameters significantly improved in both Group I and Group II compared to preoperative values. Although these parameters and left ventricular wall motion did not improve in the 7 cases with an EDVI over 140ml/m2 in Group II, the clinical results of these 7 cases were good during the follow-up period except one case which preoperatively had frequent ventricular arrythmia. The clinical condition improved remarkably in the 3 patients who had preoperative angina pectoris among these 7 cases. Surgical indications must be carefully determined in cases with increased EDVI and frequent ventricular arrythmia. |
| Author | Suda, Hisao Natsuaki, Masafumi Itoh, Tsuyoshi Norita, Hiroaki Naitoh, Kouzou |
| Author_xml | – sequence: 1 fullname: Naitoh, Kouzou organization: Department of Thoracic Surgery, Saga Medical School – sequence: 1 fullname: Norita, Hiroaki organization: Department of Thoracic Surgery, Saga Medical School – sequence: 1 fullname: Itoh, Tsuyoshi organization: Department of Thoracic Surgery, Saga Medical School – sequence: 1 fullname: Natsuaki, Masafumi organization: Department of Thoracic Surgery, Saga Medical School – sequence: 1 fullname: Suda, Hisao organization: Department of Thoracic Surgery, Saga Medical School |
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| References | 16) Kron, I. L., Lerman, B. B., Haines, D. E. et al.: Coronary bypass grafting in patients with ventricular fibrillation. Ann. Thorac. Surg. 48: 85-89, 1989. 19) Kron, I. L., Flanagan, T. L., Blackbourne, L. H. et al.: Coronary revascularization rather than cardiac transplantation for chronic ischemic cardiomyopathy. Ann. Surg. 210: 348-354, 1989. 17) Magovern, J. A., Magovern, G. J. Sr. and Maher, T. D. Jr.: Operation for congestive heart failure: transplantation, coronary artery bypass, cardiomyoplasty. Ann. Thorac. Surg. 56: 418-425, 1993. 11) Hung, J., Kelly, D. T., Baird, D. K. et al.: Aorto-coronary bypass grafting in patients with severe left ventricular dysfunction. J. Thorac. Cardiovasc. Surg. 79: 718-723, 1980. 14) Mickleborough, L. L., Maruyama, H., Takagi, Y. et al.: Results of revascularization in patients with severe left ventricular dysfunction. Circulation (Suppl. II) 92: 73-79, 1995. 5) Sheehan, F. H., Bolson, E. L., Dodge, H. T. et al.: Advantages and applications of the centerline method for characterizing regional ventricular function. Circulation 74: 293-305, 1986. 3) Christakis, G. T., Weisel, R. D., Fremes, S. E. et al.: Coronary artery bypass grafting in patients with poor ventricular function. J. Thorac. Cardiovasc. Surg. 103: 1083-1092, 1992. 10) 河内寛治, 川田哲嗣, 小林修一ほか: 技術的困難例における冠状動脈バイパス手術-時に低左室機能例の手術対策-. 日胸外会誌44: 376-378, 1996. 21) Rahintoola, S. H.: The hibernating myocardium in ischemia and congestive heart failure. Eur. Heart J. (Suppl. A) 14: 22-26, 1993. 23) 夏秋正文, 伊藤翼, 富田伸司ほか: 虚血性心疾患のバイパス手術例における Blood Cardioplegia の至適温度に関する臨床的検討. 日胸外会誌43: 990-996, 1995. 4) Greene, D. G., Carlisle, R., Grant, C. et al.: Estimation of left ventricular volume by one-plane cineangiography. Circulation 35: 61-69, 1967. 18) Burch, G. E., Giles, T. D. and Colcolough, H. L.: Ischemic cardiomyopathy. Am. Heart J. 79: 291-292, 1970. 20) Dilsizian, V. and Bonow, R. O.: Current diagnostic techniques of assessing myocardial viability in patients with hibernating and stunned myocardium. Circulation 87: 1-17, 1993. 7) Miller, D. C., Stinson, E. B. and Alderman, E. L.: Surgical treatment of ischemic cardiomyopathy: Is it ever too late? Am. J. Surg. 141: 688-693, 1981. 9) 遠藤真弘, 佐藤渉, 西田博ほか: 高度低左心機能の虚血性心筋症 (Ischemic cardiomyopathy) に対する冠動脈バイパス術の適応と限界および成績. 日外会誌97: 227-233, 1996. 13) Elefteriades, J. A., Tolis, G., Levi, E. et al.: Coronary artery bypass grafting in severe left ventricular dysfunction: excellent survival and improved EF and functional state. J. Am. Coll. Cardiol. 22: 1411-1417, 1993. 6) Luciani, G. B., Faggian, G., Razzolini, R. et al.: Severe ischemic left ventricular failure: Coronary operation or heart transplantation? Ann. Thorac. Surg. 55: 719-723, 1993. 2) Zubiate, P., Kay, J. H. and Mendez, A. M.: Myocardial revascularization for the patients with drastic impairment of function of the left ventricle. J. Thorac. Cardiovasc. Surg. 73: 84-86, 1977. 1) Oldham, H. N., Kong, Y., Bartel, A. G. et al.: Risk factors in coronary artery bypass surgery. Arch. Surg. 105: 918-923, 1972. 15) Kaul, T. K., Agnihotri, A. K., Fields, B. L. et al.: Coronary artery bypass grafting in patients with an ejection fraction of twenty percent or less. J. Thorac. Cardiovasc. Surg. 111: 1001-1012, 1996. 22) Rankin, J. S., Feneley, M. P., Hickey, M. S. et al.: A clinical comparison of mitral valve repair versus valve replacement in ischemic mitral regurgitation. J. Thorac. Cardiovasc. Surg. 95: 165-177, 1988. 8) Louie, H. W., Laks, H., Milgalter, E. et al.: Ischemic cardiomyopathy: Criteria for coronary revascularization and cardiac transplantation. Circulation 84 (Suppl. III): 290-295, 1991. 12) Hellman, C., Schmidt, D. H., Kamath, M. L. et al.: Bypass graft surgery in severe left ventricular dysfunction. Circulation (Suppl. I) 62: 103-110, 1980. |
| References_xml | – reference: 14) Mickleborough, L. L., Maruyama, H., Takagi, Y. et al.: Results of revascularization in patients with severe left ventricular dysfunction. Circulation (Suppl. II) 92: 73-79, 1995. – reference: 6) Luciani, G. B., Faggian, G., Razzolini, R. et al.: Severe ischemic left ventricular failure: Coronary operation or heart transplantation? Ann. Thorac. Surg. 55: 719-723, 1993. – reference: 11) Hung, J., Kelly, D. T., Baird, D. K. et al.: Aorto-coronary bypass grafting in patients with severe left ventricular dysfunction. J. Thorac. Cardiovasc. Surg. 79: 718-723, 1980. – reference: 15) Kaul, T. K., Agnihotri, A. K., Fields, B. L. et al.: Coronary artery bypass grafting in patients with an ejection fraction of twenty percent or less. J. Thorac. Cardiovasc. Surg. 111: 1001-1012, 1996. – reference: 10) 河内寛治, 川田哲嗣, 小林修一ほか: 技術的困難例における冠状動脈バイパス手術-時に低左室機能例の手術対策-. 日胸外会誌44: 376-378, 1996. – reference: 3) Christakis, G. T., Weisel, R. D., Fremes, S. E. et al.: Coronary artery bypass grafting in patients with poor ventricular function. J. Thorac. Cardiovasc. Surg. 103: 1083-1092, 1992. – reference: 13) Elefteriades, J. A., Tolis, G., Levi, E. et al.: Coronary artery bypass grafting in severe left ventricular dysfunction: excellent survival and improved EF and functional state. J. Am. Coll. Cardiol. 22: 1411-1417, 1993. – reference: 19) Kron, I. L., Flanagan, T. L., Blackbourne, L. H. et al.: Coronary revascularization rather than cardiac transplantation for chronic ischemic cardiomyopathy. Ann. Surg. 210: 348-354, 1989. – reference: 1) Oldham, H. N., Kong, Y., Bartel, A. G. et al.: Risk factors in coronary artery bypass surgery. Arch. Surg. 105: 918-923, 1972. – reference: 20) Dilsizian, V. and Bonow, R. O.: Current diagnostic techniques of assessing myocardial viability in patients with hibernating and stunned myocardium. Circulation 87: 1-17, 1993. – reference: 5) Sheehan, F. H., Bolson, E. L., Dodge, H. T. et al.: Advantages and applications of the centerline method for characterizing regional ventricular function. Circulation 74: 293-305, 1986. – reference: 8) Louie, H. W., Laks, H., Milgalter, E. et al.: Ischemic cardiomyopathy: Criteria for coronary revascularization and cardiac transplantation. Circulation 84 (Suppl. III): 290-295, 1991. – reference: 12) Hellman, C., Schmidt, D. H., Kamath, M. L. et al.: Bypass graft surgery in severe left ventricular dysfunction. Circulation (Suppl. I) 62: 103-110, 1980. – reference: 17) Magovern, J. A., Magovern, G. J. Sr. and Maher, T. D. Jr.: Operation for congestive heart failure: transplantation, coronary artery bypass, cardiomyoplasty. Ann. Thorac. Surg. 56: 418-425, 1993. – reference: 22) Rankin, J. S., Feneley, M. P., Hickey, M. S. et al.: A clinical comparison of mitral valve repair versus valve replacement in ischemic mitral regurgitation. J. Thorac. Cardiovasc. Surg. 95: 165-177, 1988. – reference: 23) 夏秋正文, 伊藤翼, 富田伸司ほか: 虚血性心疾患のバイパス手術例における Blood Cardioplegia の至適温度に関する臨床的検討. 日胸外会誌43: 990-996, 1995. – reference: 4) Greene, D. G., Carlisle, R., Grant, C. et al.: Estimation of left ventricular volume by one-plane cineangiography. Circulation 35: 61-69, 1967. – reference: 7) Miller, D. C., Stinson, E. B. and Alderman, E. L.: Surgical treatment of ischemic cardiomyopathy: Is it ever too late? Am. J. Surg. 141: 688-693, 1981. – reference: 21) Rahintoola, S. H.: The hibernating myocardium in ischemia and congestive heart failure. Eur. Heart J. (Suppl. A) 14: 22-26, 1993. – reference: 16) Kron, I. L., Lerman, B. B., Haines, D. E. et al.: Coronary bypass grafting in patients with ventricular fibrillation. Ann. Thorac. Surg. 48: 85-89, 1989. – reference: 9) 遠藤真弘, 佐藤渉, 西田博ほか: 高度低左心機能の虚血性心筋症 (Ischemic cardiomyopathy) に対する冠動脈バイパス術の適応と限界および成績. 日外会誌97: 227-233, 1996. – reference: 18) Burch, G. E., Giles, T. D. and Colcolough, H. L.: Ischemic cardiomyopathy. Am. Heart J. 79: 291-292, 1970. – reference: 2) Zubiate, P., Kay, J. H. and Mendez, A. M.: Myocardial revascularization for the patients with drastic impairment of function of the left ventricle. J. Thorac. Cardiovasc. Surg. 73: 84-86, 1977. |
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| Title | Evaluation of Postoperative Cardiac Function in Severe Ischemic Heart Disease Associated with Decreased Ejection Fraction |
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