Objective : To evaluate the early and midterm outcome in patients with coronary artery disease (CAD) and severe left ventricular (LV) dysfunc­tion, as defined by ejection fraction (LV EF) less than 35%, after coronary artery bypass grafting (CABG).
Patients and methods : From April 1999 to June 2002, ninety seven pa­tients with CAD and EF < 35% had isolated CABG surgery. Preoperative-ly, patients were evaluated by history, physical examination, 12-leads ECG, echocardiographic study, and cardiac cathetenzation. In elective cases, via­bility studies were performed. All pa­tients had on pump CABG surgery. Patients were managed in the cardiac surgical ICU. After discharge, patients were followed up regularly in the car-
diology out-patients clinic.
Results: There were 76 males and 21 females. History of prior myocar-dial infarction was present in 46%. The main presenting symptoms were angina pectoris, heart failure, cardio-genie shock and pulmonary edema. Preoperatively, 59% of the patients were in New Your Heart Association Classification (NYHA) class III or IV. Coronary angiography revealed left main or triple vessel disease in 82%. More than half of the patients (54%) had moderately to severely dilated LV. The LV EF was: 30 - 35% in 26; 25 - 30% in 54; and 20 - 25% in 17 patients. All patients had LV wall mo­tion abnormalities which were found in more than 2 segments. Intra-aortic balloon pump was used in 36 pa­tients. . The average number of coro-