SURGICAL REVASCULARIZATION IN ISCHEMIC CARDIOMYOPATHY WITH FIXED PERFUSION DEFECT

Abstract

Objective: The object of study was to evaluate our six years data of surgicalrevascularization in ischemic cardiomyopathy.

Methodology: This descriptive cross sectional study was conducted at NationalInstitute of cardiovascular diseases Karachi from January 2007 to January 2014.Patients were followed for 6 months. All the patients with IschemicCardiomyopathy who underwent coronary artery bypass grafting and had apreoperative left ventricular ejection fraction less than or equal to 35% wereincluded. Left ventricular ejection fraction was determined by transthoracicechocardiography. Indication for surgery was predominance of anatomicalnature of coronary artery disease. Functional improvement was evaluatedthrough NYHA class improvement.

Results: A total of 34 patients were included in this study. There were 22 (64.7%)males and 12 (35.3%) females with mean age of 69.3 years. An average of 2.9 ±0.67 coronary bypass grafts per patient were performed. In-hospital mortalitywas 14.7% (5 patients). The 6 month survival rate was 92.8%. While NYHA calssimprovement was observed in 52.9% of survivors at six month.

Conclusion: In selected patients with severe ischemic left ventricular dysfunctionand no tissue viability, coronary artery bypass grafting is high risk procedure.Improvement in functional class was documented in survivors. CABG may beconsidered in ischemic cardiomyopathy in selected cases.