Abstract
Background: Coronary artery bypass graft surgery (CABG) in patients with left ventricular dysfunction was associated with improved survival compared to medical treatment. We aimed to evaluate the short-term outcome of CABG in patients with an ejection fraction of ≤ 40%.
Methods: Forty patients with ejection fraction (EF) ≤40% underwent CABG between December 2015 and August 2019. Patients with moderate to severe mitral regurgitation, concomitant severe liver and kidney impairment, re-operative CABG, who had concomitant procedures with CABG were excluded. The mean age was 56.72±12.44 years; 30 patients (75%) were males. Twenty-six patients (65%) were diabetics, 28 patients (70%) were hypertensive, 18 patients (45%) were dyslipidemic, 22 patients (55%) were smokers and 4 patients (10%) were obese. The preoperative ejection fraction ranged from 20% to 40%, with a mean of 34.62%
Results: Mean cardiopulmonary bypass time was 90.8 minutes, and ischemic time was 49.8 minutes. Seventeen patients (42.5%) needed inotropic support intraoperatively, and 16 patients (40%) needed an intra-aortic balloon. Five patients (12.5%) had postoperative ischemia, one patient (2.5%) had re-exploration for bleeding, and one patient (2.5%) had acute renal failure. The mean ICU stay was 70.5± 45.63 hours, hospital stay was 8.9± 4 days, and three patients (7.5%) had operative mortality. After 6 months operatively, the ejection fraction improved to reach a mean value of 39.87± 5.02% compared to the preoperative ejection fraction of 32.8± 8.8%. (p<0.001)
Conclusion: Coronary artery bypass grafting can be performed safely in patients with depressed left ventricular function with low short-term morbidity and mortality.