Abnormal Regional Metabolism and Mechanical Function in Patients with Ischemic Heart Disease Improvement after Successful Regional Revascularization by Aortocoronary Bypass

Left ventricular anterior wall metabolism was investigated concurrently with global myocardial metabolism by simultaneous preoperation sampling of anterior interventricular venous (AIV) and coronary sinus (CS) as well as arterial bloods in seven patients with severe obstructive lesions of the major coronary arteries, including left anterior descending. Postoperative study was performed two weeks to six months following successful aortocoronary artery bypass surgery. All grafts including the aorto-left anterior descending artery grafts were patent. Preoperatively in three of the seven patients, anterior wall lactate extraction (R%L) was negative at rest. The average R%L at rest (7 ± 14%) was abnormal and was negative (-49 ± 26%) at a maximum supraventricular pacing rate (MPR) of 137 ± 4.6 beats/min. Postoperatively, not only was resting R%L (39 + 4.4% ) normal but also it remained normal during atrial pacing (32 ± 8.5% )