Immediate effects of coronary artery bypass grafting on left ventricular systolic function and relaxation: Relation to previous myocardial infarction

1995 ◽  
Vol 3 ◽  
pp. 152-152
Author(s):  
Y FURUTANI ◽  
Y SHIMAZAKI ◽  
K TANIGUCHI ◽  
T TAKAHASHI ◽  
H MATSUDA
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Systolic Function ◽  
Artery Bypass ◽  
Left Ventricular Systolic Function ◽  
Left Ventricular ◽  
Bypass Grafting ◽  
Previous Myocardial Infarction ◽  
Ventricular Systolic Function

Ejection Fraction Recovery after Coronary Artery Bypass Grafting for Ischemic Cardiomyopathy

2021 ◽  
Author(s):  
Vasileios Ntinopoulos ◽  
Nestoras Papadopoulos ◽  
Dragan Odavic ◽  
Achim Haeussler ◽  
Omer Dzemali
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Ischemic Cardiomyopathy ◽  
Systolic Function ◽  
Artery Bypass ◽  
Left Ventricular Systolic Function ◽  
Left Ventricular ◽  
Bypass Grafting ◽  
Ventricular Systolic Function

Abstract Background Controversy exists about left ventricular systolic function recovery after coronary artery bypass grafting in patients with ischemic cardiomyopathy. The aim of this study is to evaluate the temporal evolvement of left ventricular systolic function after coronary artery bypass surgery in patients with ischemic cardiomyopathy. Patients and Methods A total of 50 patients with coronary artery disease and left ventricular ejection fraction (LVEF) ≤35% underwent isolated coronary artery bypass grafting in a single center in the period 2017 to 2019. We performed a retrospective analysis of the echocardiographic and clinical follow-up data at 3 months and 1 year postoperatively. Results Median LVEF preoperatively was 25% (20–33%), mean patient age was 66 ± 8.2 years, 33 (66%) patients were operated off-pump, and 22 (44%) procedures were non-elective. There was no in-hospital myocardial infarction, stroke, and repeat revascularization. Three (6%) patients underwent re-exploration for bleeding or tamponade. In-hospital mortality was 8% and 1-year mortality was 12%. At 1 year postoperatively, there was no repeat revascularization, no myocardial infarction, 1 (2.6%) patient had a transient ischemic attack, and 10 (20%) patients required an implantable defibrillator. There was a statistically significant median ejection fraction increase at 3 months (15% [5–22%], p < 0.0001) and 1 year (23% [13–25%], p < 0.0001) postoperatively, with an absolute increase ≥10% in 32 (74.4%) and 30 (78.9%) patients at 3 months and 1 year, respectively. Conclusion Patients with ischemic cardiomyopathy undergoing coronary artery bypass surgery show continuous recovery of left ventricular systolic function in the first postoperative year.

An Atypical Presentation of Acute Coronary Syndrome

2012 ◽  
Vol 8 (1) ◽  
pp. 67
Author(s):  
Syed Khurram Mushtaq Gardezi ◽  
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Systolic Function ◽  
Artery Bypass ◽  
Left Ventricular Systolic Function ◽  
Regional Wall Motion ◽  
Dobutamine Stress ◽  
Left Ventricular ◽  
Ventricular Systolic Function ◽  
Coronary Syndrome

A 61-year-old man was admitted to hospital with severe occipital headache and weakness and numbness of the left arm. His electrocardiograms showed changes hinting at acute coronary syndrome (ACS). However, in view of his clinical presentation, he underwent tests for likely subarachnoid haemorrhage, but this was ruled out. The next day, he was referred to cardiology. A transthoracic echocardiogram showed reduced left ventricular systolic function along with regional wall motion abnormalities involving inferoposterior walls. The patient was treated as per the protocol for ACS. A dobutamine stress echocardiogram confirmed inferior myocardial infarction with evidence of myocardial viability in the affected left ventricular segments. Subsequent investigations confirmed three-vessel coronary artery disease and reduced left ventricular systolic function. The patient underwent successful coronary artery bypass grafting.

scholarly journals Preoperative Factors Influencing the Results of Coronary Artery Bypass Grafting with Reduced Left Ventricular Myocardial Contractility

2020 ◽  
pp. 38-42
Author(s):  
S. A. Rudenko ◽  
Y. V. Kaschenko ◽  
L. A. Klimenko ◽  
N. S. Osipenko ◽  
A. V. Rudenko ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Myocardial Contractility ◽  
Artery Bypass ◽  
Left Ventricular ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

Myocardial infarction remains one of the most common causes of disability in patients. Prior myocardial infarction in 15–30% of cases leads to decrease in left ventricle (LV) contractility. Isolated drug therapy is ineffective in most cases – impressions of the coronary arteries require revascularization, including coronary artery bypass grafting. Data on the choice of optimal tactics in such patients is also limited. In addition, there is no consensus on the prognosis of mortality and management of this group of patients. Materials and methods. The study included 190 patients with the left ventricular ejection fraction (EF LV) of 35% or less, who underwent CABG at the National Amosov Institute of Cardiovascular Surgery of the NAMS of Ukraine in the period from 01.01.2015 to 31.12.2018. The age of patients ranged from 29 to 83 years (61.13 ± 8.87). There were 170 men (89.47%) and 20 women (10.53%). Our data suggests that patients with low EF LV have complications typical of coronary artery bypass grafting, but the incidence of these complications is higher and increases with the EF LV decrease (except for the central nervous system (CNS) complications where there is no correlation). At the same time, such indicators as the duration of mechanical ventilation, the number of days of stay in the intensive care unit and the total number of days of stay in the hospital are increasing. The following complications most often arose in the postoperative period: acute heart failure, respiratory failure, renal failure. Based on our data, we came to the following conclusions: in patients with reduced LV myocardial contractility, the main complications after coronary artery bypass grafting were congestive heart failure, respiratory failure, renal failure and CNS complications. Among them, regardless of the level of EF LV, the most common were acute heart failure and complications of the respiratory system. The most significant factors of preoperative condition of patients with reduced LV myocardial contractility, which increase the risk of postoperative complications and increased mortality are: EF LV 30% and below, patient age over 60 years, creatinine rise to >200 mmol/L, pulmonary hypertension over 50 mmHg. Concomitant mitral regurgitation (moderate or severe) requires obligatory intraoperative correction.

scholarly journals Effect of pericardial incision on left ventricular morphology and systolic function in patients during coronary artery bypass grafting

2020 ◽  
Author(s):  
Lan-Ting Zhao ◽  
Lu Liu ◽  
Ping-Ping Meng ◽  
Yong-Huai Wang ◽  
Meng Li ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Circumferential Strain ◽  
Systolic Function ◽  
Artery Bypass ◽  
Radial Strain ◽  
Left Ventricular ◽  
Bypass Grafting ◽  
Sphericity Index ◽  
Lv Systolic Function

Abstract Background: Accurate assessment of left ventricular (LV) systolic function is important after coronary artery bypass grafting (CABG). LV ejection fraction (LVEF) is conventionally used to evaluate LV systolic function; deformation parameters can be used to detect subtle LV systolic dysfunction. It is unclear whether an incised pericardium without sutures during CABG could affect LV morphology and function. We investigated the effect of pericardial incision on LV morphology and systolic function during CABG. Methods: Intraoperative transesophageal echocardiography was performed in 27 patients during elective off-pump beating heart CABG 5 minutes before and after pericardial incision. LV longitudinal and mid-cavity transversal diameters, sphericity index, volumes, and LVEF were measured. LV global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS), and twist obtained by two-dimensional speckle tracking echocardiography were measured simultaneously. Results: LV mid-cavity transversal diameter increased, while the LV sphericity index decreased (P<0.001) immediately after pericardial incision. The GLS, GCS, and twist significantly decreased, while the GRS notably increased (P<0.001). The LV volumes and LVEF remained unchanged. Conclusions: Pericardial incision immediately transformed LV morphology from an ellipsoid to sphere, with decreased longitudinal and circumferential strain and twist, and increased radial strain, while LVEF remained unchanged. This should be considered when evaluating LV systolic function in patients after CABG.

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