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Complete Revascularization Showed A Better Cardiac Function Improvement In Patients With Low Ejection Fraction

Tri Wisesa Soetisna1, Wiraga Adi Nugraha2, Fitri Setyani Rokim3

  • 1Department of Cardiothoracic and Vascular Surgery, National Cardiovascular Centre Harapan Kita, Jakarta, Indonesia. tricts2000@yahoo.com.

The Heart Surgery Forum
|July 5, 2022
PubMed

Insights

Patients with low preoperative ejection fraction (EF) (<35%) showed significant improvement in cardiac function after coronary artery bypass grafting (CABG). This suggests revascularization of hibernating myocardium benefits patients with reduced EF.

Area of Science:

  • Cardiology
  • Cardiac Surgery

Background:

  • Coronary artery bypass grafting (CABG) is a common surgical intervention for coronary artery disease.
  • Preoperative left ventricle ejection fraction (EF) is a crucial indicator of cardiac function and prognosis.
  • The impact of preoperative EF on postoperative outcomes after CABG warrants further investigation.

Purpose of the Study:

  • To compare the postoperative ejection fraction (EF) changes in patients undergoing elective on-pump CABG.
  • To analyze outcomes based on preoperative left ventricle EF, specifically comparing groups with EF <35% and EF >35%.

Main Methods:

  • A retrospective study of 660 patients undergoing elective on-pump CABG between 2018-2019.
  • Patients were stratified into two groups: preoperative EF <35% (Group A, n=72) and EF >35% (Group B, n=588).
  • The primary endpoint was the change in EF from pre- to postoperative measurements.

Main Results:

  • Both groups showed no significant difference in cardiopulmonary bypass (CPB) and aortic clamp (AxC) durations.
  • A significant difference in EF transformation was observed between Group A (2.91+10.31) and Group B (-0.14+4.57) (P < 0.001).
  • Group A experienced significantly longer ICU stays and required more postoperative ventilatory support compared to Group B.

Conclusions:

  • Patients with lower preoperative EF (<35%) demonstrated a greater improvement in cardiac function post-CABG.
  • The observed improvement may be attributed to the revascularization of hibernating myocardium.
  • This finding suggests that CABG can be beneficial for improving cardiac function in patients with severely reduced EF.
Abstract

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