Abstract
The impact of preoperative impaired left ventricular ejection fraction (EF) in octogenarians following coronary bypass surgery on short-term survival was evaluated in this study. A total of 147 octogenarians (mean age 82.1 ± 1.9 years) with coronary artery diseases underwent elective coronary artery bypass graft between January 2000 and December 2009. Patients were stratified into: Group I (n = 59) with EF >50%, GroupII (n = 59) with 50% > EF >30% and in Group III (n = 29) with 30% > EF. There was no difference among the three groups regarding incidence of COPD, renal failure, congestive heart failure, diabetes, and preoperative cerebrovascular events. Postoperative atrial fibrillation was the sole independent predictive factor for in-hospital mortality (odds ratio (OR), 18.1); this was 8.5% in Group I, 15.3% in Group II and 10.3% in Group III. Independent predictive factors for mortality during follow up were: decrease of EF during follow-up for more that 5% (OR, 5.2), usage of left internal mammary artery as free graft (OR, 18.1), and EF in follow-up lower than 40% (OR, 4.8). The results herein suggest acceptable in-hospital as well short-term mortality in octogenarians with impaired EF following coronary artery bypass grafting (CABG) and are comparable to recent literature where the mortality of younger patients was up to 15% and short-term mortality up to 40%, respectively. Accordingly, we can also state that in an octogenarian cohort with impaired EF, CABG is a viable treatment with acceptable mortality.
Highlights
In the last several decades the number of the patients with impaired left ventricular ejection fraction (EF) due to ischemic cardiomyopathy has increased
The impact of preoperative impaired left ventricular ejection fraction (EF) in octogenarians following coronary bypass surgery on short-term survival was evaluated in this study
The results suggest acceptable in-hospital as well short-term mortality in octogenarians with impaired EF following coronary artery bypass grafting (CABG) and are comparable to recent literature where the mortality of younger patients was up to 15% and shortterm mortality up to 40%, respectively
Summary
In the last several decades the number of the patients with impaired left ventricular ejection fraction (EF) due to ischemic cardiomyopathy has increased. Improvements in medical therapies and surgical techniques have been achieved, the management of patients with coronary artery disease (CAD) and low EF is still challenging. Since life expectancy in western countries is constantly increasing, and we believe it is just a matter of time until this patient group will be regularly addressed to the surgery. The aim of this retrospective study was to evaluate intra-operative and mid-term follow up results after primary CABG in patients with moderate to severe impaired preoperative left ventricular function being treated in the period between January 2000 and December 2009
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