Influence of Varying Degrees of Intraoperative Hemolysis on Left Ventricular Ejection Fraction After Coronary Artery Bypass Grafting

Studies have been conducted on 123 patients with coronary artery disease with CABG. The assessment of the degree of IOH is made by the level of free hemoglobin (Hb). In accordance with the level of [Hb] at the end of the operation, patients with CABG surgery are divided into three groups: 1 – without IOH (Hb≤ 0,1 g/l), n = 43, 2 – with low IOH (l IOH, Hb> 0,1 g/l and <0,5 g/l, n=42), 3 – with high IOH (hIOH, Hb≥ 0,5 g/l, n=38). This study demonstrates a clear association between intraoperative hemolysis (IOH) and diminished postoperative left ventricular ejection fraction (LVEF) recovery in patients with coronary artery disease undergoing coronary artery bypass grafting. While CABG generally improves LVEF, the degree of this improvement is significantly attenuated by the severity of IOH. This suggests that IOH plays a detrimental role in myocardial recovery following CABG. Our findings contribute to a deeper understanding of the pathophysiological mechanisms underlying complications arising from CABG. The negative correlation between free hemoglobin levels and postoperative LVEF indicates that the hemolytic process itself may contribute to impaired cardiac function. This warrants further investigation into the specific pathways involved, such as the inflammatory cascade and oxidative stress induced by free hemoglobin release.