Survival predictors in patients with a left ventricular ejection fraction of 10-30% receiving a coronary bypass: analysis of preoperative variables

• Published in: Cardiovascular surgery (London, England) Vol. 1; no. 5; p. 558
• Main Authors: Hausmann, H, Warnecke, H, Ennker, J, Topp, H, Schiessler, A, Hempel, B, Friedel, N, Schmitt, D, Hetzer, R
• Format: Journal Article
• Language: English
• Published: England 01.10.1993
• Subjects: Adult; Aged; Aged, 80 and over; Angina Pectoris - mortality; Angina Pectoris - physiopathology; Angina Pectoris - surgery; Angina, Unstable - mortality; Angina, Unstable - physiopathology; Angina, Unstable - surgery; Cardiac Output, Low - mortality; Cardiac Output, Low - physiopathology; Cardiac Output, Low - surgery; Cause of Death; Coronary Artery Bypass; Coronary Disease - mortality; Coronary Disease - physiopathology; Coronary Disease - surgery; Female; Follow-Up Studies; Hemodynamics - physiology; Humans; Male; Middle Aged; Myocardial Infarction - mortality; Myocardial Infarction - physiopathology; Myocardial Infarction - surgery; Postoperative Complications - mortality; Postoperative Complications - physiopathology; Prospective Studies; Risk Factors; Survival Rate; Ventricular Function, Left - physiology
• ISSN: 0967-2109
• DOI: 10.1177/096721099300100518

A total of 224 patients with angina pectoris and a left ventricular ejection fraction in the range of 10-30% (mean 24.2%) underwent coronary artery bypass grafting between April 1986 and August 1991. These patients received a mean (s.d.) of 2.9 (0.3) aortocoronary vein grafts. The overall operative mortality rate was 8.9%. The 1-, 2- and 3-year survival rates were 87.7%, 86.7% and 85.2%, respectively. Analysis of operative risk factors showed that patients with an end-diastolic left ventricular pressure > 24 mmHg were significantly more at risk (mortality rate 20.0%, P < 0.05) than those with an end-diastolic left ventricular pressure < or = 24 mmHg (mortality rate 6.2%). Patients with a perioperative cardiac index < 2.5 l min-1m-2 had higher mortality (25.4%) than those with a cardiac index > or = 2.5 l min-1m-2 (mortality 1.9%, P < 0.001). The operative mortality rate of patients with a cardiac index < 2.5 l min-1m-2 and an end-diastolic left ventricular pressure > 24 mmHg was 40.5%. Patients with a left ventricular ejection fraction of 10-20% were not significantly more at risk (P > 0.05) than those with a left ventricular ejection fraction of 21-30%.