Coronary Bypass Surgery for Patients with Chronic Poor Preoperative Left Ventricular Function (EF < 30%): 5-year Follow-up

Background Optimal therapy for patients with coronary artery disease and chronic poor left ventricular function, given the absence of randomized trials, is unclear. Although coronary surgery has been performed in such patients for 25 years, it is perceived as high risk and unproven long-term benefit, especially if thallium scanning fails to demonstrate large areas of viability. We report the results of coronary surgery in these patients. Methods Retrospective analysis by a standardized patient questionnaire, of 107 such consecutive patients offered coronary surgery. Results Mean follow-up was 3.3 years (range, 0.5–5.5); average patient age was 64.4 ± 1 years. Preoperative thallium scans were performed solely on 31 patients with none or mild angina, of which 10 (32%) demonstrated large areas of viable myocardium. Perioperative mortality was 1.9%. On multivariate analysis, factors predictive of increased perioperative death were recent myocardial infarction ( p p Conclusion Offering coronary surgery to these patients irrespective of thallium testing is safe and effective in the medium term. Early surgery is recommended.