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Coronary artery bypass for advanced left ventricular dysfunction

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Surgical Options for the Treatment of Heart Failure

Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 225))

Abstract

Although courageous forays into the application of coronary artery bypass grafting (CABG) to the patient with advanced left ventricular dysfunction were made since the early davs of open heart surgery, the opinion that the patient with advanced left ventricular dysfunction could not and should not be offered coronary artery bypass surgery prevailed well into the 1980’s. The reluctance centered around three concerns: (1) that the risk of operation would be prohibitive, (2) that little symptomatic or longevity benefit would accrue from CABG, and (3) that CABG would merely punctuate an inevitable course of inexorable deterioration. Cardiologists were therefore reluctant to refer such patients for coronary revascularization and surgeons were reluctant to accept such patients. In terms of scientific evaluation, most large multicenter trials of coronary artery bypass grafting purposely excluded patients with advanced left ventricular dysfunction. (Ejection fraction was >35/a in the Coronary Artery Surgery Study (CASS) and >50% for the European Coronary Surgery Study (ECSS)).1,2

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Authors
  1. John A. Elefteriades
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  2. George Tellides
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  3. Habib Samady
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  4. Meher Yepremyan
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  5. Umer Darr
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  6. Franz J. Th. Wackers
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  7. Barry Zaret
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Editor information

Editors and Affiliations

  1. Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario, Canada

    Roy G. Masters MD FRCSC

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© 1999 Kluwer Academic Publishers

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Elefteriades, J.A. et al. (1999). Coronary artery bypass for advanced left ventricular dysfunction. In: Masters, R.G. (eds) Surgical Options for the Treatment of Heart Failure. Developments in Cardiovascular Medicine, vol 225. Springer, Dordrecht. https://doi.org/10.1007/978-0-585-29191-8_2

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  • DOI: https://doi.org/10.1007/978-0-585-29191-8_2

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-0-7923-6130-5

  • Online ISBN: 978-0-585-29191-8

  • eBook Packages: Springer Book Archive

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