Isom O W, Spencer F C, Glassman E, Dembrow J M, Pasternack B S
Circulation. 1975 Aug;52(2 Suppl):I141-7.
To assess the influence of coronary revascularization on the long-term survival of patients with debilitating angina and significant impairment of left ventricular function, analysis was done of 62 consecutive patients with severe angina and hypokinetic left ventricles (LVED larger than or equal to 20) undergoing coronary bypass at N.Y.U. Medical Center between January, 1971 and May 1974. Follow-up was 98% complete, range 4 to 41 months with a mean of 23 months. Multiple bypasses were done in 94% of the group; a left-ventricular scar was excised in 16%. There were six operative deaths (mortality 9.7%) and three late deaths, all within eight months after operation. Angina was either absent or substantially improved in 90% of surviving patients. Life-table analysis shows a two-year survival of 85%, very similar to the survival rate for patients with good ventricular function. Hence, with current techniques impaired ventricular function is not a major contraindication to bypass grafting.
为评估冠状动脉血运重建对患有顽固性心绞痛且左心室功能严重受损患者长期生存的影响，对1971年1月至1974年5月间在纽约大学医学中心接受冠状动脉搭桥手术的62例连续的严重心绞痛且左心室运动功能减退（左室舒张末期内径大于或等于20）患者进行了分析。随访完成率为98%，范围为4至41个月，平均为23个月。该组94%的患者进行了多次搭桥手术；16%的患者切除了左心室瘢痕。有6例手术死亡（死亡率9.7%）和3例晚期死亡，均在术后8个月内。90%的存活患者心绞痛消失或明显改善。生命表分析显示两年生存率为85%，与心室功能良好患者的生存率非常相似。因此，就目前的技术而言，心室功能受损并非旁路移植术的主要禁忌证。
