Apstein C S, Kline S A, Levin D C, Baltaxe H A, Killip T
Am Heart J. 1977 May;93(5):547-55. doi: 10.1016/s0002-8703(77)80002-1.
Left ventircular performance and graft patency were studied postoperatively at 2 weeks in 19 patients, and at 9 months in 15 patients. At early follow-up, left ventricular ejection fraction and mean rate of circumferential shortening were unchanged for the group as a whole, but were slightly improved in patients who had had a moderately abnormal preoperative ejection fraction of 0.30 to 0.60. At late follow-up, 10 of 14 patients had occluded at least one graft or the proximal segment of the grafted coronary artery and had an associated decrease in ventricular function. The risk of graft occlusion was greater if the preoperative ejection fraction was decreased; seven of 10 patients with a preoperative EF of less than 0.60 suffered one or more graft occlusions, but only three of 16 patients with a preoperative EF greater than 0.60 had a postoperative graft occlusion (p is less than 0.05). The results suggest that bypass graft surgery is not generally indicated as a measure to improve ventricular function in patients with ischemic heart disease.
对19例患者在术后2周、15例患者在术后9个月进行了左心室功能和移植血管通畅情况的研究。在早期随访时，整个组的左心室射血分数和平均圆周缩短率未发生变化，但术前射血分数中度异常（0.30至0.60）的患者略有改善。在晚期随访时，14例患者中有10例至少有一支移植血管或移植冠状动脉的近端节段发生闭塞，并伴有心室功能下降。如果术前射血分数降低，移植血管闭塞的风险更大；术前EF小于0.60的10例患者中有7例发生了一次或多次移植血管闭塞，但术前EF大于0.60的16例患者中只有3例术后发生移植血管闭塞（p<0.05）。结果表明，一般不建议将搭桥手术作为改善缺血性心脏病患者心室功能的措施。
