Prognosis in patients rejected for coronary revascularization surgery
Gross, H.; Vaid, A.K.; Cohen, M.V.
American Journal of Medicine 64(1): 9-20
1978
ISSN/ISBN: 0002-9343 PMID: 146430 Document Number: 134656
The clinical course, catheterization data, and coronary and left ventricular angiograms of 231 patients rejected for coronary revascularization surgery during 1971-1974 and treated conservatively were evaluated. Based on analysis of available data, patients were classified into 1 of 8 groups as follows: 66 patients with poor left ventricular function, 43 with atherosclerotic distal coronary vessels, 1 with advanced age, 13 with isolated stenosis of the left circumflex coronary artery, 14 with non-jeopardized collaterals to myocardium beyond the critical coronary stenosis, 25 with akinetic or dyskinetic myocardium beyond the critical coronary stenosis and 19 with coronary lesions of 50-74% of the luminal diameter were rejected. Ejection fraction was an important prognostic tool. The extent and severity of coronary artery disease and the condition of the myocardium were important chiefly as they affected ejection fraction. Distal vessel disease did not affect survival adversely. Extensive vascular and myocardial damage was compatible with a long survival and productive life.