Ist die operative Myokard-revaskularisation bei stark eingeschrankter linksventrikularer Funktion sinnvoll?

Myocardial revascularization in patients with ischemic cardiomyopathy achieves beneficial results. Between January 1980 and December 1993 61 patients (ejection fraction <30%) underwent coronary artery bypass grafting in the University Hospital Erlangen. Age ranged from 36 to 75 years, 95% were in the NYHA functional class III or IV. We performed 1 redo, 2 emergency procedures and 1 additional thrombendarterctomy of the carotid artery. The 30 days mortality was 1.6%. The actuarial 5-years-survival-rate was 68.3%, following complete revascularization 77.1% respectively. 93% of the survivors were in the NYHA functional class I and II (the mean duration of follow up was 51.6 months). The clinical results of operative treatment are increased in comparison with a medicamentally treatment or angioplasty, operative mortality is similar to the mortality after PTCA or heart transplantation as well as the long term survival.