Early and Late Outcome of Coronary Artery Bypass Grafting Surgery in Patients With Poor Left Ventricular Function

Abstract

Objective: Our aim of study was to determine early and late outcomes of CABG in patients with
poor left ventricular function. The CABG surgery is beneficial in patients who have poor left
ventricular function manifested by an ejection fraction 30% or even less. These are the high risk
patients but CABG surgery not only promote their survival but also improve their functional status.
They are easy victims of increased operative mortality and diminished long term survival.
Methods: In our study we identified 63 patients who underwent CABG surgery despite poor LV
function. Data was collected during their follow up visits or telephonic follow up conducted by us.
We used pre op. IABP in 2(3.17%) patients. Among these 63 patients 36(57.14%) were
documented as healthy and Stable, 9(14.29%) were expired during follow up and in 18(28.57%)
follow up was not continued because 4(6.35%) have no contact numbers and 14(22.22%) phones
were switched off. The average duration from 2008 to 2015 was taken to be 42.5 months
approximately. Each patient necessarily received atleast one IMA. : The surgical strategy
included approach through median sternotomy. All cases were started as off-pump CABG.
Elective conversion to on-pump CABG was done for cases not tolerating off-pump.
Results: In this retrospective study we have analyzed the early and late outcomes of CABG in
low EF group. Main findings of the study are an acceptable hospital mortality i.e. mortality rate
among patients with EF <30% is 1.59% at our tertiary care center However, post-surgery
complications prevailed.3 (4.7%) patients encountered deep wound infection and same ratio
suffered renal failure.We observed the early outcomes i.e. in hospital mortality evaluated to be
1.58%. These results reflect improving results of surgery in this high risk group.
Conclusion: Our study demonstrated that all of our patients received atleast one arterial graft
i.e. internal mammary artery. The minimum standard set by STS is that atleast 95% of the patients
must receive internal mammary artery. This contributes to the survival benefit of the patients and
also improves the quality of life and reduces reoperation rates. In this retrospective study we have
analyzed the outcome of CABG in low EF group. Main findings of the study are an acceptable
hospital mortality.We concluded that acceptable morbidity and mortility rates prevailed among
this high risk group at our tertiary care center. We believe that improvements in cardiac
anesthesia, surgical technique, extracorporeal perfusion, perioperative care and postoperative
management have contributed significantly to better outcomes.