Brazilian Journal of Cardiovascular Surgery (Jan 1997)

Cirurgia de revascularização do miocárdio em pacientes com cardiomiopatia isquêmica e disfunção ventricular acentuada: resultados imediatos e de longo prazo

  • Sérgio F OLIVEIRA,
  • Adib D JATENE,
  • Maria C SOLIMENE,
  • Sergio Almeida de OLIVEIRA,
  • Cláudio MENEGUETTI,
  • Fábio B JATENE,
  • Noedir A. G STOLF,
  • Fúlvio PILEGGI,
  • José Antônio F RAMIRES

DOI
https://doi.org/10.1590/S0102-76381997000100001
Journal volume & issue
Vol. 12, no. 1
p. 1

Abstract

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Objetivo: Estudar aspectos ainda não esclarecidos relacionados a parâmetros clínicos pré-operatórios de prognóstico, risco cirúrgico, benefício funcional e sobrevida a longo prazo. Métodos: Foram analisados 71 pacientes com diagnóstico de cardiomiopatia isquêmica, com fração de ejeção ventricular esquerda Purpose: To evaluate the prognosis value of preoperative parameters, surgical risk, functional benefits and long-term survival after myocardial revascularization. Methods: Seventy one patients with coronary artery disease and severe left ventricular dysfunction (left ventricular ejection fraction < 30%) and evaluated the myocardial perfusion by Tl-201 scintigraphy were studied before and after myocardial revascularization, during the hospitalar period and 48 months (avarage) of late follow up. Results: The early mortality observed was 2,8% and the survival in 5 years 62,8%. The statistical analysis related to the preoperative clinical parameters in all patients were not significant in: a) severity of congestive heart failure (CHF) or angina; b) presence of Q wave (EKG); c) presence of ischemia (Tl-201); d) left ventricular ejection fraction. The statistical analysis related to survivors and no survivors were significant: a) functional class IV of CHF; b) presence of left brunch bundle block (LBBB). Conclusion: Our results show that functional class IV of CHF and LBBB were related to bad prognosis and demonstrate the difficulty to establish preoperative clinical parameters of prognosis due to the presence of heterogeneous coronary and myocardial pattern of the ischemic cardiomyopathy. Our surgical results confirm that myocardial revascularization is a safe procedure, increases late survival and improves the quality of life of these patients with coronary artery disease and severe left ventricular dysfunction.

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