Department of Cardiac Surgery, Municipal Hospital Triemli, Zurich, Switzerland.
Thorac Cardiovasc Surg. 2022 Oct;70(7):544-548. doi: 10.1055/s-0041-1736246. Epub 2021 Dec 11.
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.
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.
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%], < 0.0001) and 1 year (23% [13-25%], < 0.0001) postoperatively, with an absolute increase ≥10% in 32 (74.4%) and 30 (78.9%) patients at 3 months and 1 year, respectively.
Patients with ischemic cardiomyopathy undergoing coronary artery bypass surgery show continuous recovery of left ventricular systolic function in the first postoperative year.
在缺血性心肌病患者中，冠状动脉旁路移植术后左心室收缩功能的恢复存在争议。本研究旨在评估冠状动脉旁路手术后缺血性心肌病患者左心室收缩功能的时间演变。
2017 年至 2019 年期间，在一家中心医院接受冠状动脉旁路移植术的 50 名冠心病和左心室射血分数（LVEF）≤35%的患者。我们对术后 3 个月和 1 年的超声心动图和临床随访数据进行了回顾性分析。
术前 LVEF 中位数为 25%（20-33%），平均患者年龄为 66±8.2 岁，33 例（66%）患者行非体外循环手术，22 例（44%）为非紧急手术。无院内心肌梗死、中风和再次血运重建。3 例（6%）患者因出血或填塞行再次探查。院内死亡率为 8%，1 年死亡率为 12%。术后 1 年，无再次血运重建、无心肌梗死，1 例（2.6%）患者发生短暂性脑缺血发作，10 例（20%）患者需要植入除颤器。术后 3 个月（15%[5-22%]， <0.0001）和 1 年（23%[13-25%]， <0.0001）的射血分数中位数有统计学意义的增加，分别有 32 例（74.4%）和 30 例（78.9%）患者术后 3 个月和 1 年的绝对增加≥10%。
接受冠状动脉旁路手术的缺血性心肌病患者在术后 1 年内左心室收缩功能持续恢复。
