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Second Congress of Cardiology and Angiology of Bosnia & Herzegovina

 

LONG TERM RESULTS AFTER MYOCARDIAL REVASCULARISATION IN PATIENTS WITH END-STAGE HEART FAILURE - EJECTION FRACTION <=20%
N. Radovanović, Lj. Petrović, B. Mihajlović, S Ničin, J. Selestiansky, M. Fabri, P. Kovačević, M. Mijatov, Z Konstantinović and S. Popović
University Clinic of Cardiovascular Surgery, Novi Sad, Yugoslavia

Material and methods: There were 397 patients (352 male, 45 female, mean age 58,1 years) in end stage heart failure -ejection fraction (EF) lower or equal to 20% who had undergone conventional surgery - myocardial revascularisation and in 32% (129/397) associated procedures such as mitral and tricuspid annuloplasty, left ventricular aneurysmectomy, etc. Previous cardiac decompensation was registered in 83% (330/397) of the patients. Mean EF was 18,9±2,2% (10-20%) mean cardiac index 2,5±0,5 lit/min/m? (1,2-3,6 lit/min/m?) mean systolic pulmonary artery pressure 38,0±13,5 mmHg (14-100 mmHg) and mean wedge 28,3 ±9,4 mmHg (10-60 mmHg). Because of diffuse and distal coronary disease in 56% (222/397) of the patients endarterectomy of coronary arteries had to be performed. Results: Postoperative mortality (PM) -30 days was 7,8% (31/397). The follow-up study was done for 216 pts.
Conclusions: In many institutions, patients with EF <=20% are considered to be inoperable, especially if they've diffuse and distal coronary disease and they are at the waiting list for cardiac transplantation. In our series PM was acceptably low -7,9% (31/397) and long term survey has shown good results. We conclude this group of patients can derive from conventional surgery.

Drugi kongres kardiologa i angiologa Bosne i Hercegovine
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