Short term Outcome of Coronary Artery Bypass Surgery in Patients with Impaired Left Ventricular Systolic Function

Authors

Abdallah Mahmoud, assistant lecturer of cardiothoracic surgery, cardiothoracic surgery department, faculty of medicine (boys), Al Azhar University, cairo, egyptFollow
Elhusseiny Gamil, professor of Cardiothorathic Surgery, Al-Azhar UniversityFollow
Zakaria Al-mashtoly, professor of Cardiothoracic Surgery ;facuty of medicine;al azhar university;cairoFollow
Bahaa El Khonizy, lecturer of Cardiothoracic Surgery; faculty of medicine; al Azhar University; CairoFollow
Medhat Refaie, Assistant professor of Cardiothoracic Surgery, faculty of medicine, al-Azhar university, CairoFollow

Corresponding Author

Mahmoud, Abdallah

Document Type

Original Article

Abstract

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.

Keywords

Coronary artery bypass grafting; Left Ventricular Systolic Function; low ejection fraction

How to Cite This Article

Mahmoud, Abdallah; Gamil, Elhusseiny; Al-mashtoly, Zakaria; El Khonizy, Bahaa; and Refaie, Medhat (2020) "Short term Outcome of Coronary Artery Bypass Surgery in Patients with Impaired Left Ventricular Systolic Function," Al-Azhar International Medical Journal: Vol. 1: Iss. 2, Article 6.
DOI: https://doi.org/10.21608/aimj.2020.23234.1121