REVERSIBILITY OF LEFT VENTRICULAR DYSFUNCTION FOLLOWING AORTO-CORONARY BY-PASS GRAFTS

Abstract

Left ventricular asynergy, a frequent cause of myocardial dysfunction in subjects with ischemic heart disease, was studied on ciné-ventriculograms obtained before and after direct coronary artery surgery in 41 patients.Following successful aorto-coronary bypass, hypokinesis of the left ventricle is completely reversible in most instances. Akinesis, on the other hand, is not totally reversible.Improvement of the contraction pattern of the ventricle, from akinesis to hypokinesis, can be noted in approximately half of the patients, whereas the others remain unchanged. Similarly, alterations of left ventricular contraction located to the inferior wall of the ventricle are not usually reversible after surgery, whereas asynergy of the anterior wall of the ventricle can be abolished or improved in most instances.The importance, difficulties and possible means of assessing the reversibility of left ventricular asynergy prior to direct coronary artery surgery are stressed.