Early Outcome of Coronary Artery Bypass Grafting in Patients with Severe Left Ventricular Dysfunction

Abstract

Background: Left ventricular dysfunction is one of the most powerful predictors of early and late outcomes in patients who undergo coronary artery bypass grafting (CABG). The aim of this study was to assess the early results of CABG that predict 30-day mortality and prolonged length of hospital stay (LOS) after CABG in patients with an ejection fraction (EF) of 30% or less.

Methods: Seven hundred seven patients who underwent CABG with EF≤30% in Tehran Heart Center between January 2002 and January 2006 were entered and compared with 9467 patients with EF>30% as the control group. Demographic and clinical characteristics and postoperative complications were considered.

Results: The thirty-day mortality rate (2.3% vs. 0.8%, P<0.0001), the mean of LOS (P<0.0001), and the mean of the length of ICU stay (P<0.0001) were higher in the severe left ventricular dysfunction group than in the control group. In patients with severe left ventricular dysfunction, the mean of NYHA score (P=0.0081), prolonged ventilation (P=0.0051), and renal failure (P=0.0606) were related to the 30-day mortality rate. Also, the prolonged LOS in these patients was correlated with the female gender (P=0.0018) and atrial fibrillation (P=0.0164).

Conclusion: Although left ventricular dysfunction is itself an important strong risk factor in patients undergoing CABG, the early outcome of CABG in patients with left ventricular dysfunction is acceptable and the management of this factor will help to reduce the mortality and total length of stay in hospital.