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Assessment of the effect of coronary artery bypass surgery on left ventricular performance must consider a variety of factors. These include patient selection, extent of revascularization, intraoperative myocardial preservation techniques, perioperative infarction, graft patency, runoff of the peripheral vascular bed, ventricular loading conditions, and drug therapy. The timing of the evaluation is important because left ventricular function changes rapidly throughout the early postoperative recovery period, and during the first 3 months after surgery the heart remains under enhanced chronotopic and inotropic stimulation by excess circulation of catecholamines [1]. It is only thereafter that a more “intrinsic” left ventricular function reflecting the overall result of surgery can be determined. |
