Primary isolated coronary artery bypass in left ventricular dysfunction: survival and predictors of survival

Abstract

Coronary angiograms of 462 patients with ejection fractions below 51% who underwent primary isolated coronary artery bypass at the Cleveland Clinic from 1981 to 1985 were available for review. They were divided into two groups: group 1 (n = 166) with severe ventricular dysfunction (ejection fraction less than 30%) and group 2 (n = 296) with moderate ventricular dysfunction (ejection fraction 31 to 50%) at a median follow-up of 5.8 years/patient. The actuarial survival was 64.3% in group 1 and 80.6% in group 2 (P = 0.0001). By multivariate analysis, congestive heart failure (P = 0.0001) was the single most important factor affecting survival for both groups. In addition, in group 1 the preoperative use of inotropes (P = 0.03) and in group 2 the presence of peripheral vascular disease (P = 0.001) affected long term survival.