[Coronary artery bypass surgery in patients with poor left ventricular function].

As the indications for coronary artery bypass grafting (CABG) among patients with poor left ventricular function remain incompletely defined, We undertook the study to assess the results of CABG surgery for a group of such patients. We retrospectively reviewed the clinical features and outcome for 7 patients with poor left ventricular function defined as an ejection fraction below 0.3 who underwent CABG. The mean age of the patients was 63 years (range, 38 to 78 years), and 4 were 70 years of age or older. All patients had history of previous myocardial infarction, and all had left main trunk stenosis or left main equivalent stenosis. The patients underwent CABG with three to six distal anastomoses (mean, 4.3/patient), the internal thoracic artery could be used in all patients, for one or two distal anastomoses (mean, 1.6/patient). Combined coronary endarterectomy was performed in 2 patients. With the exception of one 78-year-old patient with renal failure who died during the early postoperative period, all patients showed marked postoperative improvement in cardiac function. Cardiac catheterization and exercise stress test studies revealed significant improvement in left ventricular function and exercise tolerance in these six patients. These results suggest that excellent results can be obtained with CABG surgery in patients with poor left ventricular function when the viability of the myocardium in the bypassed area has been confirmed.