Abstract
BackgroundFew studies focused on evaluating the impacts of preoperative severe left ventricular dysfunction on clinical outcomes of patients undergoing off-pump coronary artery bypass grafting surgery (OPCAB). This single center retrospective study aimed to evaluate the impacts of severe left ventricular dysfunction on in-hospital and mid-term clinical outcomes of Chinese patients undergoing first, scheduled, and isolated OPCAB surgery.MethodsFrom January 2010 to December 2014, 2032 eligible patients were included in this study and were divided into 3 groups: a severe group (patients with preoperative left ventricular ejection fraction (LVEF) of ≤35%, n = 128), an impaired group (patients with preoperative LVEF of 36-50%, n = 680), and a normal group (patients with preoperative LVEF of >50%, n = 1224). In-hospital and follow-up clinical outcomes were investigated and compared.ResultsPatients in the severe group compared to the other 2 groups had higher in-hospital mortality and higher incidences of low cardiac output and prolonged ventilation. Kaplan-Meier curves showed a similar cumulative follow-up survival between the severe group and the impaired group (χ2 = 1.980, Log-rank p = 0.159) and between the severe group and the normal group (χ2 = 2.701, Log-rank p = 0.102). Multivariate Cox regression indicated that grouping was not a significant variable related to mid-term all-cause mortality. No significant difference was found in the rate of repeat revascularization between the severe group (2.4%) and the other 2 groups.ConclusionsPatients with preoperative LVEF of ≤35% compared to preoperative LVEF of >35% increased the risk of in-hospital death and incidences of postoperative low cardiac output and prolonged ventilation, but shared similar mid-term all-cause mortality and repeat revascularization after OPCAB surgery.
Highlights
Few studies focused on evaluating the impacts of preoperative severe left ventricular dysfunction on clinical outcomes of patients undergoing off-pump coronary artery bypass grafting surgery (OPCAB)
According to preoperative LVEF, 128 patients with preoperative LVEF of 35% or less were entered into the severe group, 680 patients with preoperative LVEF of 36-50% into the impaired group, and the remaining 1224 patients with preoperative LVEF of more than 50% into the normal group
This study showed an increased risk of in-hospital death and increased incidences of postoperative low cardiac output and prolonged ventilation with the severe group compared to the impaired group and the normal group in univariate factor analysis and multivariate logistic regression analysis
Summary
Few studies focused on evaluating the impacts of preoperative severe left ventricular dysfunction on clinical outcomes of patients undergoing off-pump coronary artery bypass grafting surgery (OPCAB). A large number of previous studies [1,2,3,4,5,6,7,8,9,10,11,12,13,14] focused on evaluating the impacts of preoperative severe left ventricular dysfunction (either left ventricular ejection fraction (LVEF) of ≤35% or LVEF of ≤30%) on in-hospital and follow-up outcomes of patients with coronary artery disease undergoing surgical revascularization. Few studies focused on evaluating the impacts of preoperative severe left ventricular dysfunction on in-hospital and follow-up outcomes of patients with coronary artery disease after receiving isolated offpump CABG surgery (OPCAB). It was necessary to evaluate the impacts of severe left ventricular dysfunction on in-hospital and follow-up clinical outcomes of Chinese patients with coronary artery disease who received surgical revascularization
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