Mochtar B, Laird-Meeter K, Brower R W, Verbaan N, Haalebos M M, Bos E
Thorac Cardiovasc Surg. 1985 Feb;33(1):30-3. doi: 10.1055/s-2007-1014077.
Long-term follow-up of 62 consecutive patients with severe left ventricular dysfunction (ejection fraction = less than 0.30) and disabling angina pectoris following aorto-coronary bypass surgery was investigated. Prior to surgery all patients had angina pectoris and a history of remote myocardial infarction, 35% were in congestive heart failure (CHF). Significant stenoses in 3 major coronary vessels were present in 51 patients (82%). An average of 3.5 grafts per patient were employed. Operative mortality (30 days) rate was 4.8% (3 patients) and 13 patients died during the following period. The average follow-up was 37 months (range: 6 to 116 months). At follow-up, the 5-year survival probability for these patients was 70% (SD = 9%). Thirty-one patients (67%) of the 46 survivors had complete relief of angina, but signs of CHF were still evident in 17 patients (36%). Compared to patients with ejection fractions above 0.30% (surgical mortality 1.4% and 5-year survival rate 94% (SD = 3%] the outcome of coronary artery bypass grafting in patients with poor left ventricular function showed a significantly higher surgical mortality (P = 0.03) and impaired long-term survival (P = 0.02). However, aorto-coronary bypass grafting can be performed in patients with severe left ventricular dysfunction with reasonable relief of angina and with an acceptable surgical mortality.
对62例接受主动脉冠状动脉搭桥手术后出现严重左心室功能障碍（射血分数小于0.30）和致残性心绞痛的连续患者进行了长期随访研究。术前所有患者均有心绞痛和陈旧性心肌梗死病史，35%的患者存在充血性心力衰竭（CHF）。51例患者（82%）的3支主要冠状动脉存在明显狭窄。平均每位患者使用3.5根移植血管。手术死亡率（30天）为4.8%（3例患者），在随后的时期内有13例患者死亡。平均随访时间为37个月（范围：6至116个月）。随访时，这些患者的5年生存概率为70%（标准差=9%）。46例幸存者中有31例（67%）心绞痛完全缓解，但仍有17例患者（36%）存在CHF体征。与射血分数高于0.30%的患者相比（手术死亡率1.4%，5年生存率94%（标准差=3%）），左心室功能较差的患者冠状动脉搭桥手术的结果显示手术死亡率显著更高（P=0.03），长期生存率受损（P=0.02）。然而，对于严重左心室功能障碍的患者，可以进行主动脉冠状动脉搭桥手术，可合理缓解心绞痛，且手术死亡率可接受。
