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Off-pump coronary artery bypass surgery in the left ventricular dysfunction
Sadik Eryilmaz1, Tümer Corapçioğlu, Neyyir Tuncay Eren
1Department of Cardiovascular Surgery, Faculty of Medicine, Ankara University Hospital, Ankara, Turkey. sadikeryilmaz@hotmail.com
Objective:
The purpose of this study is to report our experience in off-pump coronary artery surgery in patients who have left ventricular dysfunction.
Methods:
Off-pump coronary artery surgery was performed to 48 patients who were chosen randomly among 265 patients having two or more coronary artery disease and whose ejection fraction (EF) was less than 30%. In these patients fractioned shortening (FS) was evaluated by echocardiography, EF with multiple gated acquisition (MUGA) and ischaemic regions with myocardial perfusion scintigraphy both pre- and postoperatively. Coronary artery angiography was done to all patients at the end of the 1st year and patients were evaluated according to New York Heart Association (NYHA) classification.
Results:
There were three deaths. The clinical situations of 41 of 45 patients (91.1%) improved after the operation. These four patients who didn't improve in NYHA status were the ones in whom complete revascularization couldn't be done. The FS and EF values were significantly increased at the 1st month, and 1st year. The constant perfusion defects and irreversible damaged areas changed into dynamic myocardial tissue in the 1st year scintigraphies.
Discussion:
Off-pump CABG can be done with an acceptable mortality and clinic results in patients who have ventricular dysfunction.