Johnstone D E, Adelman A G, Weingert M, Huckell V F, Goldman B S
Can J Surg. 1980 Mar;23(2):127-31.
The results of aortocoronary bypass grafting in 29 patients with severe left ventricular dysfunction (ejection fraction less than 35%) were studied. All patients had severe angina pectoris; 17 patients has class IV heart function and 12 had class III function according to the New York Heart Association classification. Intra-aortic balloon pump support was instituted preoperatively in all patients. Three patients died in the perioperative period. Survivors were followed up for a mean period of 20 months; there were three late deaths. Sixteen patients were clinically improved; 8 had class I and 8 class II heart function at follow-up. Fourteen patients underwent cardiac catheterization postoperatively at a mean time of 19 months. Although 22 (79%) of the 28 grafts were patent, there was no significant improvement in resting left ventricular dysfunction as assessed by ejection fraction, left ventricular volume or left ventricular end-diastolic pressure. Furthermore, graft patency could not be correlated with improvement in segmental wall motion. There was a 10% operative and an 11.5% late mortality and no measurable improvement in resting left ventricular function in this study but the majority (73%) of the surviving patients experienced definite clinical improvement.
对29例严重左心室功能不全（射血分数低于35%）患者的主动脉冠状动脉搭桥术结果进行了研究。所有患者均有严重心绞痛；根据纽约心脏协会分类，17例患者心功能为IV级，12例为III级。所有患者术前均采用主动脉内球囊泵支持。3例患者在围手术期死亡。对幸存者进行了平均20个月的随访；有3例晚期死亡。16例患者临床症状改善；随访时8例心功能为I级，8例为II级。14例患者术后平均19个月接受了心脏导管检查。尽管28条移植血管中有22条（79%）通畅，但通过射血分数、左心室容积或左心室舒张末期压力评估，静息左心室功能不全并无显著改善。此外，移植血管通畅与节段性室壁运动改善无关。本研究的手术死亡率为10%，晚期死亡率为11.5%，静息左心室功能无明显改善，但大多数（73%）存活患者有明确的临床改善。
