Key result
CABG in severe LV dysfunction shows favorable short-term outcomes with ~5% in-hospital mortality.
Why the study?
Severe left ventricular dysfunction in coronary artery disease is associated with high risks and limited outcomes, warranting evaluation of hospital and short-term outcomes and adverse outcome predictors after isolated CABG.
Cohort (n=454)
No
CABG in patients with severe left ventricular dysfunction in a lower-middle-income country setting is feasible and associated with an acceptable short-term in-hospital mortality rate of 4.6%.
Supports CABG feasibility in severe LV dysfunction in lower-middle-income settings; leaves open need for randomized trials to confirm outcomes.
Introduction and objectives Severe left ventricular dysfunction (LVD) in coronary artery disease (CAD) is linked to high risks and limited outcomes. Coronary artery bypass grafting (CABG) remains a key surgical intervention for these patients. This study aimed to assess hospital and short-term outcomes in patients with severe LVD undergoing isolated CABG and identify predictors of adverse outcomes. Methodology We conducted a retrospective study of 454 patients who underwent CABG for CAD with significant LVD at Hayatabad Medical Complex between 2018 and 2024. Data were extracted from clinical records and analyzed statistically to evaluate outcomes and predictors. Results The study included 454 patients with a mean age of 58.14 ± 9.576 years and a mean ejection fraction of 35.59 ± 3.996%. There were 396 (87.2%) male patients with common comorbidities, including hypertension (122, 26.9%), diabetes mellitus (88, 19.4%), and smoking (39, 8.6%). Intraoperative findings showed a mean cardiopulmonary bypass (CPB) time of 155.94 ± 38.120 minutes, with 451 (99.3%) achieving LIMA (left internal mammary artery) to LAD (left anterior descending artery) revascularization. Postoperative in-hospital mortality was 21 (4.6%), re-intubation occurred in 18 (4.0%), and arrhythmias were observed in 26 (5.7%). Wound infections were minimal (444 (97.8%) without infection), and 406 (89.4%) underwent elective CABG, while nine (2.0%) had emergent CABG, mostly due to ventricular septal rupture. Conclusion CABG remains a vital surgical intervention for patients with severe LVD, offering favorable short-term outcomes despite the inherent risks. Key factors contributing to these results include comprehensive myocardial revascularization, effective use of internal mammary artery grafting, and advanced myocardial protection strategies. This study highlights the potential of CABG to improve survival and functional outcomes in this high-risk population.
No takes yet. Share an insight, caveat, or question.
Aasim et al. (2025) conducted a cohort in Coronary artery disease with severe left ventricular dysfunction (n=454). Coronary artery bypass grafting (CABG) was evaluated on All-cause mortality (in-hospital mortality). Coronary artery bypass grafting in patients with severe left ventricular dysfunction resulted in a 4.6% in-hospital mortality rate, demonstrating favorable short-term outcomes despite inherent risks.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: