Severe @entity296 , characterized by @entity2026 , or @entity2845 areas with hypokinesis of the remaining wall, and a very low ejection fraction (EF), has been considered to be a contraindication for coronary revascularization (CABG). However, @entity296 and echo-stress data have shown that hypo- or @entity2845 areas can regain their contractility. Therefore, we expanded the indications for CABG, and performed operations even upon @entity1 who were waiting for a heart transplant. Between January 1993 and June 1995, among 352 @entity1 who underwent CABG, 85 had highly depressed left ventricular function. Their resting EF was lower than 0.35, and in 27 it was lower than 0.25. Viable areas of myocardium were found in all of the @entity1 through the combination of scintigraphy and @entity452 -echocardiography: these areas depended on significant coronary lesions. The mean age of the @entity1 was 48.2 years (range 33-62 years); angina was present in 62 @entity1 . A mean of 3.1 grafts/ @entity1 were implanted; enoximone was used in all but 5 @entity1 upon weaning from cardiopulmonary bypass; intra-aortic balloon pump was used in 9 cases. Operative mortality was 10.6% (9 @entity1 ), due to @entity998 in 5, acute @entity583 in 2, @entity75 in 1, and @entity1576 in 1. At the 6-month follow-up, EF was improved in all but 7 @entity1 , in whom it remained unchanged. Scintigraphic and echocardiographic tests revealed good function in most of the areas that had been previously recognized as hypo- or @entity2845 . These results suggest that the indications for standard myocardial revascularization can be expanded, and a promising option can be offered to @entity1 who may otherwise be destined to wait for an uncertain transplantation.

Severe XXXX and coronary revascularization.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity296 :: ('MESH:D009202', 'Disease') :: ['myocardial dysfunction', 'myocardial scintigraphy'] @entity452 :: ('MESH:D004280', 'Chemical') :: ['dobutamine'] @entity998 :: ('MESH:D002303', 'Disease') :: ['low-output syndrome'] @entity75 :: ('MESH:D001927', 'Disease') :: ['cerebral damage'] @entity2845 :: ('MESH:D018476', 'Disease') :: ['akinetic'] @entity2026 :: ('MESH:D001037', 'Disease') :: ['global hypokinesis'] @entity1576 :: ('MESH:D012131', 'Disease') :: ['respiratory failure'] @entity583 :: ('MESH:D009203', 'Disease') :: ['myocardial infarction']
@entity296 :: (MESH:D009202,Disease) :: ['myocardial dysfunction']
