Long-term results of coronary artery bypass grafting procedure in the presence of left ventricular dysfunction and hibernating XXXX .

@entity1 @entity712 @entity452 @entity4214 @entity951 @entity1562 @entity1002
OBJECTIVE: Long-term left ventricular (LV) performance and @entity1 outcome after coronary artery bypass grafting (CABG) procedure in the presence of depressed LV function and hibernating @entity1562 (HM) have been poorly determined. Therefore, we prospectively evaluated @entity1 undergoing CABG with severe @entity1002 and HM to elucidate postoperative prognosis. METHODS: We enrolled 120 consecutive @entity1 undergoing CABG with severe @entity1002 and HM as assessed by @entity452 echocardiography and by rest-redistribution radionuclide ( @entity4214 -201) study. Mean @entity1 age was 60+/-9 years (range 31-77 years). Mean preoperative LVEF was 28%+/-9 (range 10-40%). All @entity1 underwent echocardiographic study to assess LV recovery of function intraoperatively, prior to hospital discharge, at 3 months, at 1 year, and yearly during the follow-up. Univariate and multivariate analysis were performed to to evaluate predictors of postoperative survival. RESULTS: There were 2 hospital (1.6%) and 15 late (12.5%) deaths, mainly for @entity712 , leading to an actuarial survival of 80+/-6% and 60+/-9% at 5 and 8 years, respectively. LVEF significantly improved perioperatively (from 28+/-9% to 40+/-2%, P<0.01). Increase in LVEF, however, was gradually offset over the time (EF of 33+/-9%, 32+/-8%, and 30+/-9% at 3 months, and 12 months, and 8 years after surgery, respectively). Furthermore, @entity1 who experienced limited LV functional recovery perioperatively had a more remarkable decline of LVEF thereafter, and suffered from recurrence of @entity712 (freedom from @entity712 82+/-5% and 60+/-8% at 4 and 8 years respectively). Advanced preoperative NYHA Class, and age were independent risks factors for reduced postoperative survival. @entity951 and use of arterial conduits apparently did not influence @entity1 morbidity and mortality at long term. CONCLUSION: CABG procedure in the presence of HM enhances LV recovery of function and has a favourable prognosis. Functional benefit of the left ventricle, however, appears to be time-limited, despite remarkable improvement in @entity1 functional capacity. Advanced preoperative @entity712 , minimal perioperative improvement of LVEF, and age account for a poor long-term prognosis.
