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Published on: March 27, 2018
The Effectiveness of Coronary Artery Bypass Grafting in Patients with Left Ventricular Dysfunction
Salih Salihi1, Halil İbrahim Erkengel1, Hakan Saçlı1
1Department of Cardiovascular Surgery, Sakarya University, Faculty of Medicine, Sakarya, Turkey.
Insights
Coronary artery bypass grafting (CABG) in patients with left ventricular dysfunction (LVD) shows improved ejection fraction and survival rates. This study indicates CABG is a safe and effective option for LVD patients, enhancing their quality of life.
Area of Science:
- Cardiology
- Cardiac Surgery
- Echocardiography
Background:
- Coronary artery bypass grafting (CABG) in patients with left ventricular dysfunction (LVD) presents significant surgical challenges.
- The effectiveness of CABG in this patient population remains a subject of debate.
Purpose of the Study:
- To evaluate the effectiveness and outcomes of CABG in patients diagnosed with LVD.
Main Methods:
- Retrospective analysis of 160 patients with left ventricular ejection fraction (LVEF) ≤ 45% who underwent elective isolated CABG.
- Preoperative echocardiographic data and postoperative follow-up data were collected and analyzed.
Main Results:
- Overall hospital mortality was 5%.
- Mean LVEF significantly improved post-surgery (38.78% to 43.29%, P<0.01).
- Late survival, freedom from reintervention, and congestive heart failure rates were 86.3%, 88.7%, and 89.4%, respectively.
Conclusions:
- CABG can be performed with low morbidity and mortality in LVD patients.
- Patients with LVD can benefit from CABG, experiencing improved LV systolic function and enhanced quality of life.
Introduction:
Coronary artery bypass grafting (CABG) in patients with left ventricular dysfunction (LVD) remains a surgical challenge and is still controversial. The aim of this study was to evaluate the effectiveness of CABG in patients with LVD.
Methods:
This retrospective study included a total of 160 consecutive patients (133 males, 27 females, mean age 62.1±10.12 years [range 37 to 86 years]) who had a left ventricular ejection fraction (LVEF) ≤ 45% determined by echocardiography and underwent elective isolated CABG between September 2013 and December 2018. Preoperative echocardiographic data, such as ejection fraction, left ventricular (LV) end-systolic diameter, and LV end-diastolic diameter, were collected and evaluated. Preoperatively, 85 (53.13%) patients were in New York Heart Association functional class III or IV and the mean LVEF was 38.65±5.72% (range 20 to 45).
Results:
The overall hospital mortality was 5% (eight patients). Late follow-up was obtained in 152 (90%) cases (median follow-up time was 56,5 [3-87] months postoperatively). During follow-up, mortality developed in 11.3% (16 patients). Mean LVEF increased significantly from 38.78±5.59% before surgery to 43.29±8.46% after surgery (P<0.01). Mean late survival, freedom from coronary reintervention, and congestive heart failure rates were 86.3±3.3%, 88.7±3.9%, and 89.4±3.1%, respectively.
Conclusion:
In patients with LVD, CABG can be performed with low postoperative morbidity and mortality rates. Patients with LVD could benefit from coronary bypass surgery regarding postoperative LV systolic function and higher quality of life.
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