Acquired Paradoxic Septal Motion Following Successful Coronary Artery Bypass Surgery

Abstract

High fidelity ultrasound tracings were recorded in 45 patients pre-operatively and following bypass surgery. At the time of study, biplane cineangiography was performed in each patient. Post-operatively, twelve patients were noted to have developed striking paradoxic movement of the septum. Seven of nine patients with good left anterior oblique cines showed significantly reduced septal motion, whereas two demonstrated improved septal motion. Seven patients had undergone left internal mammary to left anterior descending bypass, all of which were patient postoperatively. Two patients with improved septal motion by cine did not receive a bypass into the LAD. One patient underwent successful right internal mammary to the right coronarv artery bypass and one patient resection of an LV aneurysm. Common to all but these two was severe two or three vessel disease with reduced ejection fractions. However, ejection fractions improved in ten of the patients postoperatively.