Early Results of Coronary Artery Bypass Graft (CABG) in Patients with Low Ejection Fraction ()
Affiliation(s)
1Cardiology Department, Faculty of Medicine, Menoufia University, Al Minufya, Egypt.
2Cardiology Department, National Heart Institute, Cairo, Egypt.
3Cardiology Department, Police Academy, Cairo, Egypt.
ABSTRACT
Background: Patients with ischemic heart disease and reduced ejection fraction have increased risk for postoperative complications and mortality. Our aim was to evaluate the effect of low EF (<40%) on the early outcomes after CABG and identify the predictors of mortality. Methods: From August 2018 to November 2019, 170 consecutive patients underwent CABG. Group 1 included 120 patients with EF (<40%; 37.49 ± 2.89%); 94 were men (78.3%), and the mean age was 55.83 ± 8.04 years. Group 2 included fifty patients having EF (>40; 57.90% ± 2.27%), 41 were men (82.0%), and the mean age was 54.30 ± 7.01 years and used as a control group. Results: Overall 30-day mortality was 10/120 patients (8.3%). Factors associated with higher mortality were females (70.0% vs. 17.3%, P < 0.001); older age (61.40 ± 7.01 vs. 55.32 ± 7.97 years, P = 0.025); diabetes mellitus (100% vs. 51.8%; P = 0.003); longer cardiopulmonary bypass time (148.70 ± 40.12 vs. 108.49 ± 36.89 min; P = 0.012); longer cross clamp time (88.19 ± 31.94 vs. 64.77 ± 22.67 min; P = 0.049), longer total operative time (6.82 ± 1.03 vs 5.38 ± 0.95 hours; P = 0.001); intra-aortic balloon pump (IABP) insertion (90.0% vs. 10.9%; P < 0.001); intra-operative complications (60% vs. 1.8%, P < 0.001); ventricular tachycardia and ventricular fibrillation (30% and 50% vs. 4.5% and 5.5% respectively; P = 0.002 for both); myocardial infarction (70% vs 11.8%, P < 0.001), and lower postoperative ejection fraction (21.46 ± 1.93 vs 40.30 ± 8.19%, P < 0.001). In patients with low EF, postoperative NYHA and CCS angina class have improved compared to the preoperative levels (1.50 ± 0.61 vs. 3.31 ± 0.56; P < 0.001 and 1.38 ± 0.52 vs. 3.11 ± 0.55; P < 0.001 respectively). Conclusion: CABG in EF < 40% is associated with more complications compared with those had EF higher than 40%; however, the clinical and echocardiographic parameters improved over time.
Share and Cite:
El-Shafey, W. , Elnagar, T. , Kamal, A. and Kamal, A. (2020) Early Results of Coronary Artery Bypass Graft (CABG) in Patients with Low Ejection Fraction.
World Journal of Cardiovascular Diseases,
10, 319-328. doi:
10.4236/wjcd.2020.105030.