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Left Ventricular Performance During Exercise Before and One Year After Aortocoronary Bypass Surgery for Angina Pectoris

Approximately one year after aorta-to-coronary saphenous vein bypass surgery, no significant change was observed between preoperative and postoperative left ventricular end-diastolic pressure or stroke work index during exercise in a group of 23 patients with patent grafts, nor in 8 subjects with all grafts occluded. However, among patients with patent grafts, significant improvement was noted in a subset of 9 patients with hypokinesis on preoperative ventriculograms, whereas no change occurred in subsets with either akinesis or normal contraction. Furthermore, a return to a normal end-diastolic pressure during exercise was observed in 6 of 18 patients with an abnormal response before surgery, and these patients with patent grafts had no previous myocardial infarction and no akinesis at left ventriculography. Most of these 6 completely improved patients had complete correction of significantly stenosed arteries, and all had successful bypass to the left anterior descending artery.It is concluded that left ventricular performance improves during exercise following surgery in patients without previous myocardial infarction, with patent grafts to the left anterior descending coronary artery, and most frequently with successful bypass to all significantly stenosed coronary arteries.