[Severe chronic XXXX . Determinants of surgical risk and long-term clinical outcome].

@entity1 @entity712 @entity339 @entity951 @entity741 @entity453 @entity67
INTRODUCTION: In @entity1 with @entity741 , a severe @entity67 is associated with a higher operative risk and to a worse late clinical outcome. However, when there is sufficient viable myocardium, surgical revascularization can improve ventricular performance and above all the functional capacity and survival of these @entity1 . OBJECTIVES: To analyze long-term results of a large series of @entity1 with an ejection fraction < or = 0.30 that underwent isolated coronary artery bypass surgery and to investigate factors, mainly clinical, that determined favorable clinical results: being that the @entity1 was alive and free of incapacitating symptoms. @entity1 AND METHODS: This series included 100 @entity1 , 93 males and 7 females, with a mean age of 62 +/- 8 years. The predominant clinical manifestation was @entity951 in 37, @entity712 in 22 and both in 41. Seventy-nine @entity1 were in functional class III or IV, and 19 had emergency surgery. RESULTS: There were 10 in-hospital deaths, 6 of which occurred in @entity1 who had emergency surgery. Mortality in the elective cases was 4.9%. Only age (p < 0.05), functional class (p < 0.05) and emergency surgery (p < 0.0001) were identified as independent predictors of early mortality. Actuarial survival rates after 5 and 8 years were 65 and 52% respectively. Long-term clinical outcome was considered favorable in 66 @entity1 . We did not find any preoperative clinical variables that were predictors of the clinical outcome. Only preoperative @entity339 correlated with a poor long-term clinical result. CONCLUSIONS: @entity1 with chronic and severe @entity67 secondary to @entity453 have an acceptable surgical risk when they are operated on electively, before their clinical condition deteriorates. Long-term results are satisfactory in the majority of the @entity1 . In these types of @entity1 clinical manifestations are of limited value in the selection process for surgical revascularization.
