ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Georg Kleikamp
Nils Reiss
Reiner Körfer
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Kleikamp, G.
Right arrow Articles by Körfer, R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kleikamp, G.
Right arrow Articles by Körfer, R.
Related Collections
Right arrow Coronary disease

Ann Thorac Surg 2003;75:1406-1412
© 2003 The Society of Thoracic Surgeons

Original article: cardiovascular

Determinants of mid- and long-term results in patients after surgical revascularization for ischemic cardiomyopathy

Georg Kleikamp, MD, PhDa*, Ariane Maleszka, MDa, Nils Reiss, MDa, Benjamin Stüttgen, MDa, Reiner Körfer, MD, PhDa

a Department of Thoracic and Cardiovascular Surgery, Heart Center of Northrhine-Westfalia, University Hospital Ruhr-University Bochum, Bad Oeynhausen, Germany

Accepted for publication November 12, 2002.

* Address reprint requests to Dr Kleikamp, Klinik für Thorax- und Kardiovaskularchirurgie, Herzzentrum Nordrhein-Westfalen, Universitätsklinik Ruhr-Universität Bochum, Georgstr 11, 32545 Bad Oeynhausen, Germany
e-mail: gkleikamp{at}hdz-nrw.de

BACKGROUND: The revascularization of patients suffering from ischemic cardiomyopathy is possible with acceptable perioperative mortality and morbidity. Many publications have discussed the problem of predicting myocardial viability, whereas the quality of the peripheral coronary vessels has been focused on less frequently.

METHODS: We studied 908 consecutive patients with ischemic cardiomyopathy revascularized between January 1, 1988 and April 30, 2000. Death, recurrent heart failure, hospitalization due to cardiac causes, ventricular assist device implantation, heart transplantation, and ventricular arrhythmias were defined as adverse events. To analyze the importance of pre- and perioperative variables (state of the coronary arteries, myocardial viability, complete vs incomplete revascularization, urgency of the operation, previous operations, gender, diabetes, preoperative New York Heart Association class, age, number of grafts, and ischemic time), a proportional hazards model was used.

RESULTS: The most important predictors of short- and long-term event-free survival were the quality of the coronary arteries, followed by myocardial viability, complete revascularization, number of bypass grafts, and an elective operation.

CONCLUSIONS: The coronary vascular system can be described by means of a simple scoring system. A good or at least moderate coronary artery perfusing an area of dysfunctional yet viable myocardium is the main predictor of a successful perioperative course and an event-free survival. Patients with a poor coronary vasculature regardless of myocardial viability should not be considered suitable for revascularization.




This article has been cited by other articles:


Home page
 Ann. Thorac. Surg.Home page
M. Pocar, A. Moneta, A. Grossi, and F. Donatelli
Coronary Artery Bypass for Heart Failure in Ischemic Cardiomyopathy: 17-Year Follow-Up
Ann. Thorac. Surg., February 1, 2007; 83(2): 468 - 474.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
M. Di Mauro, G. Di Giammarco, G. Vitolla, M. Contini, A. L. Iaco, A. Bivona, L. Weltert, and A. M. Calafiore
Impact of No-to-Moderate Mitral Regurgitation on Late Results After Isolated Coronary Artery Bypass Grafting in Patients With Ischemic Cardiomyopathy
Ann. Thorac. Surg., June 1, 2006; 81(6): 2128 - 2134.
[Abstract] [Full Text] [PDF]

Home page
 RadiologyHome page
R. M. Setser, T. P. O'Donnell, N. G. Smedira, J. F. Sabik, S. S. Halliburton, A. E. Stillman, and R. D. White
Coregistered MR Imaging Myocardial Viability Maps and Multi-Detector Row CT Coronary Angiography Displays for Surgical Revascularization Planning: Initial Experience
Radiology, November 1, 2005; 237(2): 465 - 473.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
M. Zimarino, A. M. Calafiore, and R. De Caterina
Complete myocardial revascularization: between myth and reality
Eur. Heart J., September 2, 2005; 26(18): 1824 - 1830.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
J. J. DeRose Jr, I. K. Toumpoulis, S. K. Balaram, J. P. Ioannidis, S. Belsley, R. C. Ashton Jr, D. G. Swistel, and C. E. Anagnostopoulos
Preoperative prediction of long-term survival after coronary artery bypass grafting in patients with low left ventricular ejection fraction
J. Thorac. Cardiovasc. Surg., February 1, 2005; 129(2): 314 - 321.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
G. Kleikamp, A. Maleszka, and R. Korfer
Reply
Ann. Thorac. Surg., October 1, 2004; 78(4): 1516 - 1517.
[Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
H. Hausmann, R. Meyer, H. Siniawski, R. Pregla, M. Gutberlet, H. Amthauer, R. Felix, and R. Hetzer
Factors excercising an influence on recovery of hibernating myocardium after coronary artery bypass grafting
Eur. J. Cardiothorac. Surg., July 1, 2004; 26(1): 89 - 95.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
D. S. Bach
Viability, prognosis, revascularization, and pascal
J. Am. Coll. Cardiol., December 17, 2003; 42(12): 2106 - 2108.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2003 by The Society of Thoracic Surgeons.