Hemodynamic and transesophageal echocardiographic analysis of global and regional myocardial functions, before and immediately after coronary artery bypass surgery

AIM: We investigated the effect of coronary artery bypass grafting (CABG) surgery on global and regional myocardial function; before and immediately after coronary artery bypass grafting and 1 month after the operation. METHODS: Twenty-five patients who were undergoing elective CABG were evaluated. Transesophageal echocardiography (TEE) was used to evaluate both global and regional myocardial function. Intraoperative TEE images of the left ventricle were obtained after cannulation but before cardiopulmonary bypass (CPB), 5 and 30 minutes after the termination of CPB. Same time, hemodynamic parameters were recorded. Transesophageal echocardiography evaluation was repeated one month after the operation. RESULTS: Global left ventricular function was significantly depressed 5 minutes after CPB. At the 30 minutes after CPB, left ventricular function has returned to pre-CPB baseline levels. Global left ventricular function was significantly increased at 30 days following CABG surgery. The myocardial segments that were normal before CABG had reduced contractile functions at 5 minutes after CABG but normal segments showed a significant improvement from 5 to 30 minutes. The function of this region could not reach its initial status. The segments that had severe impairments of contractile function before the revascularization showed significant improvements at 30 minutes following CABG. CONCLUSIONS: In conclusion, a successful coronary revascularization provides an improvement in contractility in cases with chronic regional left ventricular dysfunction that is not related to irreversible necrosis.