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Published on: March 27, 2018
[Coronary artery bypass grafting in patients with severe left ventricular systolic dysfunction: Short- and long-term
M Tribak1, M Konaté2, S Saidi2
1Service de chirurgie cardiovasculaire B, Hôpital Ibn-Sina, Université Mohamed V, Rabat, Maroc.
Insights
Coronary artery bypass grafting offers acceptable outcomes for patients with ischemic heart disease and severe left ventricular systolic dysfunction. This surgical intervention demonstrates manageable hospital risks and promising long-term survival rates.
Area of Science:
- Cardiology
- Cardiac Surgery
- Vascular Surgery
Background:
- Ischemic heart disease with severe left ventricular systolic dysfunction (LVEF≤35%) carries a poor prognosis.
- Coronary artery bypass grafting (CABG) is the standard treatment, despite associated surgical risks.
Purpose of the Study:
- To evaluate the short- and long-term outcomes of CABG in patients with ischemic heart disease and severe left ventricular systolic dysfunction (LVEF≤35%).
Main Methods:
- A cohort of 171 patients with ischemic heart disease and LVEF≤35% underwent isolated CABG between May 1995 and December 2010.
- Outcomes assessed included hospital mortality, postoperative morbidity, all-cause death, cardiovascular death, and major adverse cardiovascular events.
- Mean follow-up duration was 9.3±5 years.
Main Results:
- Hospital mortality was 9.9%, with postoperative morbidity at 36.9%.
- Overall survival at 1, 5, and 10 years was 97.4%, 90.5%, and 43.4%, respectively.
- Freedom from major adverse cardiovascular events at 1, 5, and 10 years was 88%, 82.1%, and 38.2%, respectively.
Conclusions:
- CABG can be safely performed in patients with ischemic heart disease and severe left ventricular systolic dysfunction.
- The procedure is associated with acceptable hospital morbidity and mortality.
- Long-term survival and event-free survival rates are encouraging in this high-risk population.
Background:
Ischemic heart disease with severe left ventricular systolic dysfunction is a poor prognosis. Coronary artery bypass grafting is the gold treatment in this population, despite high surgical risk.
Aim:
The aim of our study is to evaluate the short- and long-term outcomes of coronary artery bypass grafting in patients with ischemic heart disease and severe left ventricular systolic dysfunction (LVEF≤35%).
Methods:
Between May 1995 and December 2010, 171 patients with ischemic heart disease and severe left ventricular systolic dysfunction (LVEF≤35%) underwent isolated coronary artery bypass grafting. Hospital mortality, postoperative morbidity, all-cause death, cardiovascular death, and major adverse cardiovascular events (heart failure, recurrent angina, myocardial infarction, stroke) were evaluated. The mean follow-up was 9.3±5 years.
Results:
Hospital mortality was 9.9%. Postoperative morbidity was 36.9%. Overall survival at 1-, 5- and 10-years was 97.4%, 90.5% and 43.4%, respectively. Freedom from cardiovascular death at 1-, 5- and 10-years was 98.1%, 91.8% and 55.4%, respectively. Freedom from recurrent angina at 1-, 5- and 10-years was 95.5%, 84.8% and 44.9%, respectively. Freedom from heart failure at 1-, 5- and 10-years was 89.9%, 86,8% and 53.3%, respectively. Freedom from major adverse cardiovascular events at 1-, 5- and 10-years was 88%, 82.1% and 38.2%, respectively.
Conclusion:
Based on our findings, coronary artery bypass grafting can be performed in patients with ischemic heart disease and severe left ventricular systolic dysfunction with acceptable hospital morbidity and mortality and long-term survival.
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