Abstract

BackgroundCoronary artery bypass grafting is known to be associated with better outcome in ischemic heart disease patients with low ejection fraction. We aim to demonstrate the effect of coronary artery bypass grafting (CABG) on left ventricle (LV) systolic function and to identify the predictors that adversely lead to postoperative poor outcome.ResultThis is a cross-sectional prospective study; we included 110 patients with left ventricular ejection fraction (LVEF) < 50% who underwent CABG with a mean age of 56.1 ± 12.2 years old. Those patients were classified into two groups: group I, 76 (69%) patients with LVEF > 35%, and group II, 34 (31%) patients with LVEF < 35%. Our results as regards demographic and clinical data revealed that group II patients had a significantly higher prevalence of diabetes mellitus (DM) and Euro SCORE II compared to group I patients (p = 0.05 and < 0.001 respectively); otherwise, all other clinical predictors did not differ between the two studied groups. There was a significant improvement in LVEF post-surgery (p = 0.05) in both groups with observed no significant difference recorded for in-hospital mortality rate among patients with different groups. DM, significant diastolic dysfunction, and insertion of IABP are predictors of in-hospital mortality of the patients (p = 0.001, 0.03 and < 0.001, respectively)ConclusionWe concluded that there is a significant improvement of LV systolic function after CABG and hence better survival rate. DM, significant diastolic dysfunction, and perioperative insertion of IABP are predictors of mortality after cardiac surgery. Special care should be provided to such patients to improve their outcome

Highlights

  • Coronary artery bypass grafting is known to be associated with better outcome in ischemic heart disease patients with low ejection fraction

  • We concluded that there is a significant improvement of left ventricle (LV) systolic function after coronary artery bypass grafting (CABG) and better survival rate

  • Inclusion criteria Patients operated for elective isolated CABG or CABG and mitral valve (MV) repair at KAMC

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Summary

Introduction

Coronary artery bypass grafting is known to be associated with better outcome in ischemic heart disease patients with low ejection fraction. We aim to demonstrate the effect of coronary artery bypass grafting (CABG) on left ventricle (LV) systolic function and to identify the predictors that adversely lead to postoperative poor outcome. Despite improvements in medical therapy and surgical techniques, management of patients with left ventricular (LV) dysfunction and coronary artery disease undergoing cardiac surgery is still challenging [1, 2]. Coronary artery bypass grafting (CABG) has appeared to be superior to medical therapy alone for patients with low ejection fraction (EF), representing a significant clinical improvement and long-term. The aim of this study was to assess the effect of cardiac surgery on LV systolic function in patients with (2019) 71:2 abnormal preoperative systolic function and to identify the predictors that may affect the outcome in patients undergoing CABG Some have found ventricular improvement within weeks postoperatively [10, 11], while other studies have detected no change [12, 13] or a worsening of ventricular function [14].

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