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Off-pump coronary bypass for advanced left ventricular dysfunction.

F Nurözler1, S T Kutlu, G Küçük

  • 1Division of Cardiovascular Surgery, Central Hospital, Izmir, Turkey.

Cardiovascular Journal of South Africa : Official Journal for Southern Africa Cardiac Society [And] South African Society of Cardiac Practitioners
|March 30, 2007
PubMed
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Off-pump coronary bypass surgery demonstrated effective early and mid-term outcomes in patients with advanced left ventricular dysfunction and no bypassable circumflex disease. This surgical approach offers a viable option for complex cardiac cases, improving ejection fraction and survival rates.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Surgery Outcomes
  • Minimally Invasive Cardiac Procedures

Background:

  • Retrospective analysis of off-pump coronary artery bypass (CABG) in patients with advanced left ventricular dysfunction (LVD).
  • Exclusion criteria included bypassable circumflex coronary artery disease.
  • Focus on patients with ischemic cardiomyopathy and compromised heart function.

Purpose of the Study:

  • To evaluate the effectiveness and safety of off-pump coronary bypass surgery.
  • To assess early and mid-term outcomes in a specific patient cohort.
  • To analyze postoperative complications and survival rates.

Main Methods:

  • Retrospective review of 55 patients with advanced LVD undergoing off-pump CABG.
  • Analysis of pre-operative, intra-operative, and post-operative data.

Related Experiment Videos

  • Mid-term follow-up via telephone with referring cardiologists or patients.

    • Main Results:

    • Mean grafts per patient: 2.22. Early mortality: 3.6%. Significant improvement in left ventricular ejection fraction (LVEF) post-operatively.
    • Mean follow-up: 21.8 months. Mid-term survival: 97.6%. Freedom from cardiac events: 89.7%.
    • Symptomatic relief achieved in most patients, with 32.6% remaining in NYHA class III.

    Conclusions:

    • Off-pump coronary bypass is effective for patients with ischemic cardiomyopathy and no bypassable circumflex lesion.
    • The procedure yields favorable early and mid-term results in this high-risk group.
    • Supports the use of off-pump techniques for selected patients with severe left ventricular dysfunction.