Midterm outcome of off-pump CABG for severe LV dysfunction-Does LV size and function predict their midterm outcome?

Area of Science:

• Cardiovascular Surgery
• Cardiac Surgery
• Cardiology

Background:

• Surgical revascularization is superior for ischemic cardiomyopathy.
• Off-pump coronary artery bypass grafting (OP-CABG) is a safe revascularization method for high-risk patients.
• Limited data exists on postoperative ventricular function and size impact on midterm outcomes.

Purpose of the Study:

• To evaluate the midterm outcomes of OP-CABG in patients with severe left ventricular (LV) dysfunction.
• To identify predictors of operative and midterm mortality in this patient cohort.

Main Methods:

• Retrospective analysis of 211 consecutive patients undergoing OP-CABG from January 2017 to December 2018.
• Statistical analysis of operative and midterm outcomes, including mortality and major adverse cardiovascular events.
• Assessment of postoperative left ventricular ejection fraction (LVEF) and dimensions as predictors.

Main Results:

• Operative mortality was 10.9%, with preoperative NYHA class and postoperative IABP insertion as independent predictors.
• Midterm cardiac mortality was 5.8% over a mean follow-up of 3.14 years.
• Postoperative LVEF and LV dimensions were independent predictors of midterm mortality; 89% midterm MACE-free survival.

Conclusions:

• OP-CABG can achieve complete revascularization in severe LV dysfunction patients with good midterm results.
• High early operative mortality is noted, but postoperative LV function and dimensions are key predictors of midterm survival.