The Annals of Thoracic Surgery, Vol 23, 99-110, Copyright © 1977 by The Society of Thoracic Surgeons
Early and long-term effects on direct myocardial revascularization on cardiac function: a prospective study using multivariable physiological analysis
ST Raza, BA Vidne, EJ Farrell, TZ Lajos, AB Lee, G Schimert and JH Siegel
Perioperative and late follow-up hemodynamic cardiovascular studies to
assess the effects of direct myocardial revascularization on cardiac
function objectively have been completed on 51 patients. Analysis of the
data delineated three distinct groups basedon the patterns of their early
postoperative recovery. Group I patients (12) had a hyperdynamic
cardiovascular response to operation and returned to a normal physiological
range of cardiac function within 24 hours. Group II patients (24) initially
had moderate to severe myocardial decompensation postoperatively but
responded to inotropic support and moved into the normal physiological
range within 24 to 48 hours. Group III patients (15) had severe, prolonged
myocardial decompensation with little response to inotropic support. There
were no early deaths in Group I, 1 early iatrogenic death in Group II, and
2 deaths from sepsis, 1 in Group I and 1 in Group II. All 7 cardiogenic
deaths occurred in Group III patients. Late follow-up studies 4 to 23
months postoperatively have been completed on 29 patients. These showed
cardiovascular stability in the mean values in Groups I and II. Significant
improvement in mean cardiac function was seen in surviving Group III
patients.
