The Annals of Thoracic Surgery, Vol 27, 547-553, Copyright © 1979 by The Society of Thoracic Surgeons
Ventricular function and the native coronary circulation five years after myocardial revascularization
DH Tyras, N Ahmad, GC Kaiser, HB Barner, JE Codd and VL Willman
Of 531 patients who underwent coronary artery bypass grafting during 1970
to 1973, 181 were restudied by ventriculography and by graft and coronary
angiography at least 5 years following operation. Five patterns of
postoperative ventricular function were identified: improved ventricular
function resulting in normal left ventricular (LV) function; normal
ventricular function that was unchanged; abnormal ventricular function that
improved but did not reach normal; abnormal ventricular function that
remained unchanged; and deterioration of LV function. Patients who regained
(40) and those who retained normal ventricular function (49) comprise 49%
of the series and patients with deterioration of ventricular function, only
20%. Graft patency and angina relief were significantly better in those
with normal LV function than in those with LV deterioration. Progression of
disease in grafted coronary arteries was similar in all groups, but was
significantly higher in ungrafted coronary arteries (61.3%) in the patients
showing deterioration than in either the improved patients or those with an
unchanged normal LV (33.3% each) (p less than 0.05). The high incidence of
progression of disease in ungrafted coronary arteries in the group with
deterioration suggests that low graft patency and deterioration of
ventricular function in this group might both be related to intrinsic
acceleration of coronary atherosclerosis unrelated to operative
intervention.
