Early Effect of Cardiac Surgery on Left-Ventricular Ejection Fraction

  • Peter Steele
  • George Pappas
  • Michael Jenkins
  • Gerry Maddoux
  • Dennis Kirch
Part of the Topics in Cardiovascular Disease book series (TCAD)


Aortocoronary artery bypass (ACB) is being performed with increased frequency for the relief of angina in patients with coronary artery disease.1,2 Despite the satisfactory relief of angina, however, there has been concern that the operation may be associated with either deterioration or lack of improvement in left ventricular (LV) performance.3–6 In addition, there is a definite risk of intraoperative acute myocardial infarction. 7–8 Also, low cardiac output is frequently observed early after valve replacement surgery, and this may reflect LV dysfunction. Considerable attention has been paid to optimal preservation of myocardium in patients undergoing cardiac surgical procedures.


Cardiopulmonary Bypass Myocardial Blood Flow Aortic Valve Replacement Pulsatile Flow Coronary Artery Surgery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    I. Favaloro, R. G., Saphenous vein graft in the surgical treatment of coronary artery disease: Operative technique, J. Thorac. Cardiovasc. Surg. 58:178 (1969).Google Scholar
  2. 2.
    Johnson, W. D., Flemma, R. J., Lepley, D., and Ellison, E. H., Extended treatment of severe coronary artery disease: A total surgical approach, Ann. Surg. 170: 460 (1969).PubMedCrossRefGoogle Scholar
  3. 3.
    Shepherd, R. L., Itscoitz, S. B., Glancy, D. L., Stinson, E. B., Reis, R. L., Olinger, R. N., Clark, C. E., and Epstein, S. E., Deterioration of myocardial function following aorto-coronary bypass operations, Circulation 49: 467 (1974).PubMedCrossRefGoogle Scholar
  4. 4.
    Arbogast, R., Solignac, A., and Bourassa, M. G., Influence of aortocoronary saphenous vein bypass surgery on left ventricular volumes and ejection fraction. Comparison before and one year after surgery in 51 patients, Amer. J. Med. 54: 290 (1973).PubMedCrossRefGoogle Scholar
  5. 5.
    Achuff, S., Griffith, L., Humphries, J. O., Conti, C. R., Browley, R., and Goff, V., Myocardial damage after aorto-coronary vein bypass surgery (abstract), J. Clin. Invest. 51: la (1972).Google Scholar
  6. 6.
    Hammermeister, K. E., Kennedy, J. W., Hamilton, G. W., Stewart, D. K., Gould, K. L., Lipscomb, K., and Murry, J. A., Aortocoronary saphenous-vein bypass. Failure of successful grafting to improve resting left ventricular function in chronic angina, N. Engl. J. Med. 290:186 (1974).Google Scholar
  7. 7.
    Brewer, D. L., Bilbro, R. H., and Bartel, A. G., Myocardial infarction as a complication of coronary bypass surgery, Circuation 47: 58 (1973).CrossRefGoogle Scholar
  8. 8.
    Hultgren, H. N., Miyagawa, M., Buck, W., and Angell, W. V., Ischemic myocardial injury during coronary artery surgery, Amer. Heart J. 82: 624 (1971).PubMedCrossRefGoogle Scholar
  9. 9.
    Pappas, G., Winter, S. D., Kopriva, C. J., and Steele, P. P., Improvement of myocardial and other vital organ functions and metabolism with a simple method of pulsatile flow (IABP) during clinical cardiopulmonary bypass, Surgery 77: 34 (1975).PubMedGoogle Scholar
  10. 10.
    Pappas, G., Blount, S. G., and Davies, H., Supported and non-supported valve homografts in man, Ann. Thorac. Surg. 14: 513 (1972).PubMedCrossRefGoogle Scholar
  11. 11.
    Yacoub, M. H., and Kittle, C. F., A new technique for replacement of the mitral valve by semilunar valve homograft, J. Thorac. Cardiovasc. Surg. 58: 859 (1969).PubMedGoogle Scholar
  12. 12.
    Steele, P. P., Van Dyke, D., Trow, R. S., Anger, H. O., and Davies, H., Simple and safe bedside method for serial measurement of left ventricular ejection fraction, cardiac output and pulmonary blood volume, Brt. Heart J. 36: 122 (1974).CrossRefGoogle Scholar
  13. 13.
    Dodge, H. T., Sandler, H., Ballew, D. W., and Lord, J. D., The use of biplane angiocardiography for the measurement of left ventricular volume in man, Amer. Heart J. 60: 762 (1960).PubMedCrossRefGoogle Scholar
  14. 14.
    Kennedy, J. W., Trenholme, S. E., and Kasser, I. S., Left ventricular volume and mass from single plane cineangiocardiogram. A comparison of anteroposterior and right anterior oblique methods, Amer. Heart J. 80: 343 (1970).PubMedCrossRefGoogle Scholar
  15. 15.
    Greene, D. C., Carlisle, R., Grant, C., and Bunnell, I. L., Estimation of left ventricular volume by one-plane cineangiography, Circulation 35: 61 (1967).PubMedCrossRefGoogle Scholar
  16. 16.
    Trinkle, J. K., Helton, N. E., Wood, R. E., and Bryant, L. R., Metabolic comparison of a new pulsatile pump and a roller pump for cardiopulmonary bypass, J. Thorac. Cardiovasc. Surg. 58: 562 (1969).PubMedGoogle Scholar
  17. 17.
    Shepard, R. B., and Kirklin, J. W., Relation of pulsatile flow to oxygen consumption and other variables during cardio-pulmonary bypass, J. Thorac. Cardiovasc. Surg. 58: 694 (1969).PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1977

Authors and Affiliations

  • Peter Steele
    • 1
  • George Pappas
    • 1
  • Michael Jenkins
    • 1
  • Gerry Maddoux
    • 1
  • Dennis Kirch
    • 1
  1. 1.Department of Medicine and Department of SurgeryDenver Veterans Administration Hospital, University of Colorado Medical CenterDenverUSA

Personalised recommendations