CORONARY-ARTERY BYPASS-SURGERY IN PATIENTS WITH SEVERE LEFT-VENTRICULAR DYSFUNCTION

In the period 1988-91 31 patients with depressed function of the left ventricle but without valvular disease or congestive heart failure und erwent coronary arterial bypass surgery. The median number of previous infarctions was 1.7 (0-4). Four patients had no history of previous m yocardial infarction. All patients had ischemic heart disease and sign ificant stenoses of the circumflex artery, the left anterior descenden t artery, or the right coronary artery. Preoperatively the mean left-v entricular ejection fraction (LVEF) was 20 % (9-26) judged by echocard iography. The median number of peripheral anastomoses was 4.9 (2-7). T he perioperative mortality was 9.7 %. One year survival was 90 %. Post operatively the median LVEF increased to 35 % (11-50). After surgery t he working capacity increased in 71 % of the patients. This study has demonstrated that coronary arterial bypass surgery in patients with is chemic heart disease and poor left-ventricular function caused mainly by perfusion defects may result in symptomatic and functional benefit.