Left Ventricular Pump Function Before and After Aortocoronary Bypass Surgery

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Abstract
Ten patients with severe effort angina and with left ventricular dysfunction during exercise before operation underwent hemodynamic and angiographic studies on average 20 mo. after coronary artery bypass surgery. Five patients (50%) were completely asymptomatic after operation (group I). The other 5 (group II) were still limited physically because of anginal pain, although 2 were much improved. Pre-operatively, there was no significant difference in the severity of the disease, as judged from case histories, work tests and hemodynamic and angiographic findings between the 2 groups. The working capacity of the patients in group II was not increased significantly post-operatively. Their coronary arteriograms revealed unsatisfactory surgical results. In 2 patients, 1 significantly stenosed vessel was not bypassed because of poor run-off. In the other 3 patients 1 graft was closed. Left ventricular function curves showed no significant improvement of left ventricular pump function. In group I, working capacity increased significantly, all stenoses of major coronary vessels were bypassed and all grafts were patent. Left ventricular function showed an almost normal response during exercise. Left ventricular dysfunction due to ischemia apparently can be significantly improved by coronary bypass, and seems to be a good correlation between clinical, hemodynamic and angiographic findings.