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Syed Tasnim Raza
Bernardo A. Vidne
Thomas Z. Lajos
Arthur B. Lee
George Schimert
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Ann Thorac Surg 1977;23:99-110
© 1977 The Society of Thoracic Surgeons

Articles

Early and Long-Term Effects of Direct Myocardial Revascularization on Cardiac Function: A Prospective Study Using Multivariable Physiological Analysis

Syed Tasnim Raza, M.D., Bernardo A. Vidne, M.D., Edward J. Farrell, M.S., Thomas Z. Lajos, M.D., Arthur B. Lee, M.D., George Schimert, M.D., John H. Siegel, M.D.*

Department of Surgery, State University of New York at Buffalo, and Buffalo General Hospital, Buffalo, and the IBM-Thomas J. Watson Research Center, Yorktown Heights, NY.

Accepted for publication August 9, 1976.

* Address reprint requests to Dr. Siegel, Department of Surgery, Buffalo General Hospital, 100 High St, Buffalo, NY 14203.

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 based on the pattern 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.






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