Revascularization in severe left ventricular dysfunction

Eric J. Velazquez, Robert O. Bonow*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

41 Scopus citations


The highest-risk patients with heart failure with reduced ejection fraction are those with ischemic cardiomyopathy and severe left ventricular systolic dysfunction (ejection fraction ≤35%). The cornerstone of treatment is guideline-driven medical therapy for all patients and implantable device therapy for appropriately selected patients. Surgical revascularization offers the potential for improved survival and quality of life, particularly in patients with more extensive multivessel disease and the greatest degree of left ventricular systolic dysfunction and remodeling. These are also the patients at greatest short-term risk of mortality with coronary artery bypass graft surgery. The short-term risks of surgery need to be balanced against the potential for long-term benefit. This review discusses the evolving data on the role of surgical revascularization, surgical ventricular reconstruction, and mitral valve surgery in this high-risk patient population.

Original languageEnglish (US)
Pages (from-to)615-624
Number of pages10
JournalJournal of the American College of Cardiology
Issue number6
StatePublished - Feb 17 2015


  • coronary artery bypass grafting
  • coronary artery disease
  • heart failure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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