Influence of Aortocoronary Bypass Surgery on Left Ventricular Performance

Quantitative analysis of left ventricular cineangiocardiograms was performed before and after aortocoronary-vein-bypass operations for angina pectoris in 14 selected patients. Eight patients with anatomically successful results had a decrease in left ventricular end-systolic volume, and an increase in ejection fraction and the rate of circumferential fiber shortening at the ventricular equator. In two, improvement in the motion of akinetic regions of the ventricular wall was found. Six other patients had anatomically unsatisfactory results, usually because of occlusion of the graft. Ejection fraction and fiber-shortening rate fell in these, and the end-systolic volume was higher after operation. End-diastolic volume was similar in both groups and was not consistently altered by operation. In patients without severe depression of ventricular performance, ventricular function improved when the operation was technically successful. Deterioration of function accompanied graft occlusion.