Abstract

Background: We assessed the long-term outcomes of CABG comparing patients with preserved and reduced left ventricular (LV) function. Methods: Consecutive 965 patients who underwent isolated CABG between 2002 and 2016, were enrolled. Of these, 164 patients (17%) were with reduced left ventricular function (EF <40%) (Group lwEF) and the other 801 patients were with preserved LV function (Group pvEF). All CABG were performed via median sternotomy (98.2%) or small left thoracotomy either on- (21.2%) or off-pump (78.8%). Results: Mean follow-up period was 3.7 years. Mean age was 69 vs 68 years (Group pvEF vs Group lwEF) and male patients were significantly less prevalent in Group pvEF (77% vs 87%). Mean number of graft anastomoses was 3.1 vs 3.3 (P = .049). The overall survival and freedom from MACCE were significantly better in Group pvEF than Group lwEF (91% vs 78% and 70% vs 58% at 5 years, respectively). In Group lwEF, small preoperative LV end-systolic volume was independent predictor of significant EF improvement. Although the use of bilateral internal thoracic arteries (BITA) as well as off-pump CABG (OPCAB) positively affected long-term survival in Group pvEF, no significant difference was observed in Group lwEF. Conclusion: The surgical outcomes of CABG in the patients with reduced LV function was poor and BITA use or OPCAB did not provide favorable impact in those patients.

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