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Coronary artery bypass surgery in patients with severe left ventricular dysfunction
C Selim Isbir1, Tekin Yildirim, Serdar Akgun
1Department of Cardiovascular Surgery, Marmara University School of Medicine, Istanbul, Turkey.
International Journal of Cardiology
|September 6, 2003
Summary
Coronary artery bypass grafting (CABG) is feasible in patients with severe left ventricular dysfunction, offering acceptable mortality and encouraging mid-term survival. Preoperative intra-aortic balloon pump (IABP) support significantly improves outcomes.
Area of Science:
- Cardiovascular Surgery
- Cardiac Surgery
- Interventional Cardiology
Background:
- Severe left ventricular dysfunction presents significant challenges for cardiac surgery.
- Coronary artery bypass grafting (CABG) is a potential treatment option for these high-risk patients.
Purpose of the Study:
- To evaluate the role and outcomes of CABG in patients with ejection fraction (EF) below 30%.
- To identify factors influencing survival in this patient cohort.
Main Methods:
- A retrospective analysis of 212 patients with EF < 30% who underwent CABG.
- Data collected on preoperative conditions, surgical techniques (including left internal mammary artery (LIMA) use and endarterectomy), and postoperative outcomes.
- Follow-up for up to 58 months.
Main Results:
- In-hospital mortality was 5.6%.
- 1, 2, 3, and 4-year survival rates were 94%, 87%, 80%, and 73%, respectively.
- Preoperative intra-aortic balloon pump (IABP) support significantly improved operative mortality (P=0.002), while LIMA use did not impact survival.
Conclusions:
- CABG can be performed with acceptable mortality in patients with poor left ventricular function.
- Mid-term survival results following CABG for severe left ventricular dysfunction are encouraging.
- Preoperative IABP support is a critical factor in improving survival rates for these patients.