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Clinical results of coronary revascularization in left ventricular dysfunction

 Sak Lee  ;  Byung-Chul Chang  ;  Kyung-Jong Yoo  ;  Young-Lan Kwak  ;  Young-Nam Youn 
 CIRCULATION JOURNAL, Vol.71(12) : 1862-1866, 2007 
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Background An association of mitral regurgitation (MR) with ischemic cardiomyopathy (I-CMP) increases the risk of heart failure and its surgical management remains controversial. Methods and Results Between July 2001 and June 2006, a total of 49 patients with I-CMP underwent surgical ventricular restoration (SVR) and coronary revascularization with or without concomitant mitral annuloplasty (MAP). The mean age was 59.8 years, and all patients had New York Heart Association (NYHA) class III or IV heart failure (mean left ventricular ejection fraction (LVEF) = 24.8%). Nineteen patients had MR >grade 3 (MR group). SVR and coronary artery bypass grafting were performed in all patients, and concomitant MAP was performed in the MR group. Echocardiography was performed preoperatively, postoperatively, and at mean of 19 months after operation. Preoperative left ventricular (LV) end-diastolic and end-systolic dimensions, left atrial volume index, and MR grade were statistically significantly increased in the MR group. On the early postoperative echocardiogram, mean LVEF was significantly improved, with reduction of LV dimensions, in both groups; however, at follow up, these parameters were more significantly improved in the MR group, but unchanged in non-MR group, reaching almost the same levels as the non-MR group. Conclusion In patients with I-CMP, MR increases early and late mortality; however, after SVR and concomitant MAP, LV function seems to continuously improve with more significant reduction in the LV dimensions than in the non-MR group.
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1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Meyun Shick(강면식)
Yoo, Kyung Jong(유경종) ORCID logo https://orcid.org/0000-0002-9858-140X
Lee, Sak(이삭) ORCID logo https://orcid.org/0000-0001-6130-2342
Chang, Byung Chul(장병철)
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