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Ann Thorac Surg 1985;39:340-345
© 1985 The Society of Thoracic Surgeons

Articles

Improvement in Resting Ventricular Performance Following Coronary Bypass Surgery

Christo I. Tchervenkov, M.D., James F. Symes, M.D., Allan D. Sniderman, M.D., Robert Lisbona, M.D., Vilma A. Derbekyan, M.D., Richard J. Novick, M.D., J. Earl Wynands, M.D., Anthony R.C. Dobell, M.D., Jean E. Morin, M.D.*

Cardiovascular Research Unit, Royal Victoria Hospital, McGill University, Montreal, PQ, Canada

Accepted for publication July 27, 1984.

* Address reprint requests to Dr. Morin, Division of Cardiovascular Thoracic Surgery, Room S8–30, Royal Victoria Hospital, 687 Pine Ave W, Montreal, PQ, Canada H3A 1A1


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 Abstract
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To assess the changes in resting left ventricular (LV) function following coronary bypass surgery, technetium 99m–labeled multiple equilibrated blood pool gated scans were performed in 53 consecutive patients at rest, before operation, and at 24 hours and 1 week after operation. Left ventricular ejection fraction (LVEF) and end-diastolic volume (EDV) were measured.

The LVEF increased significantly from a preoperative value of 49 ± 2% to 56 ± 2% at 24 hours after operation (p < 0.05) and 56 ± 2% at 1 week following operation (p < 0.05 compared with the preoperative value). The EDV also exhibited significant changes, decreasing from a preoperative value of 148 ± 8 ml to 91 ± 11 ml at 24 hours (p < 0.001) and 114 ± 9 ml at 1 week (p < 0.01 compared with the preoperative value). When the patients were divided into two groups according to the preoperative LVEF (Group 1, LVEF of greater than or equal to 50%; Group 2, LVEF of less than 50%), the observed changes were similar.

This study demonstrates significant improvement in resting LV function 24 hours following coronary bypass surgery. This improvement persists at 1 week and is not related to the degree of preoperative impairment. We conclude that the combination of successful revascularization and optimal myocardial protection can result in significant improvement of LV function at rest.


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Presented at the 56th Scientific Sessions of The American Heart Association, Anaheim, CA, Nov, 1983.

The technical assistance of Dr. Kibe Itiaba is acknowledged.


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