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One center experience in China
Yunpeng Ling1, Xi Liu2, Yu Chen2
1Department of Cardiac Surgery, Peking University Third Hospital Beijing 100049, China.
Insights
Off-pump coronary artery bypass grafting (OPCAB) shows satisfactory outcomes for patients with coronary artery disease and low ejection fraction. Left ventricular ejection fraction (LVEF) ≤30% and recent myocardial infarction are key risk factors for long-term survival.
Area of Science:
- Cardiology
- Cardiac Surgery
- Vascular Surgery
Background:
- Coronary artery disease (CAD) with low left ventricular ejection fraction (LVEF ≤40%) presents a significant surgical challenge.
- Off-pump coronary artery bypass grafting (OPCAB) is an alternative surgical strategy for these high-risk patients.
Purpose of the Study:
- To evaluate the long-term outcomes of OPCAB in patients with CAD and severely reduced LVEF (≤40%).
- To identify independent prognostic factors influencing survival after OPCAB in this patient cohort.
Main Methods:
- A retrospective analysis of 71 patients with LVEF ≤40% who underwent OPCAB between 2001 and 2004.
- Kaplan-Meier survival analysis, log-rank tests, and Cox regression modeling were employed to assess long-term results and risk factors.
Main Results:
- The mean follow-up duration was 64.9 months. Perioperative mortality was 8.5% (6/71).
- The overall survival rates at 1, 3, 5, and 8 years were 95.1%, 93.3%, 86.3%, and 77.7%, respectively.
- Cox regression identified LVEF ≤30% (RR=6.446) and acute myocardial infarction within 30 days (RR=5.993) as independent predictors of cardiac-related death.
Conclusions:
- OPCAB can achieve satisfactory long-term outcomes in carefully selected patients with CAD and low LVEF.
- Pre-existing LVEF ≤30% and recent acute myocardial infarction are critical risk factors impacting long-term survival post-OPCAB.
Objective:
To investigate the outcomes and prognostic factors for patients with coronary artery disease and low left ventricular ejection fraction (LVEF≤40%) undergoing off-pump coronary artery bypass grafting OPCAB).
Methods:
From 2001 to 2004, 71 patients with low EF undergoing OPCABG in our hospital, the mean age is 65.0±9.0 years (from 37 to 81), 49 males and 16 females, the mean EF was 33.8±5.0%. Regular follow-up evaluation was completed. Draw the Kaplan-Meier survival curves, Use the log-rank test and Cox regression model to find out the factors that affect the long-term result.
Results:
71 low LVEF patients, 6 patients died perioperative, 63 patients discharged successfully, the follow-up time was 64.9±30.4 months. 6 patients lost of follow up, 19 patients died during follow-up including 10 patients (15.9%) who had cardiac-related death. The survival rate at 1, 3, 5 and 8 years was 95.1%, 93.3%, 86.3%, 77.7%, respectively. Univariate analysis shows EF≤30% and acute myocardial infarction within 30 days are risk factors for the long-term survival (P<0.05). Cox regression analysis showed that EF≤30% (RR=6.446, P<0.05) and acute myocardial infarction within 30 days (RR=5.993, P<0.05) are two independent risk factors for the cardiac-related death after discharge.
Conclusions:
The patients with low eject fraction ventricular have satisfactory outcomes after OPCAB. LVEF≤30% and acute myocardial infarction within 30 days are two independent risk factors that affect the long-term outcome.
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