Key result
Off-pump coronary artery bypass grafting significantly improved left ventricular ejection fraction from 35.28% to 43.22% at one month in patients with preoperative ejection fractions of 30-39%.
Why the study?
Off-pump coronary artery bypass grafting is considered a safer alternative to on-pump surgery, particularly in patients with left ventricular dysfunction, but short-term outcomes and functional improvements needed assessment.
Does off-pump coronary artery bypass grafting (OPCAB) safely improve left ventricular function and NYHA class in patients with left ventricular dysfunction (LVEF 30%-39%) compared to those with LVEF ≥40%?
Cross-Sectional (n=200)
No
Does off-pump coronary artery bypass grafting (OPCAB) safely improve left ventricular function and NYHA class in patients with left ventricular dysfunction (LVEF 30%-39%) compared to those with LVEF ≥40%?
Absolute Event Rate: 43.22% vs 55.33%
p-value: p=<0.001
Off-pump coronary artery bypass grafting is safe and provides significant short-term functional and echocardiographic improvements in patients with left ventricular dysfunction (LVEF 30%-39%).
OPCAB may support short-term LVEF gains in moderate LV dysfunction; leaves open randomized confirmation of safety and durability.
Background: Off-pump coronary artery bypass grafting (OPCAB) is considered a safer alternative to on-pump surgery, especially in patients with left ventricular dysfunction (LVD). Objectives: This study assessed short-term outcomes and functional improvements in LVD patients post-OPCAB. Methods: The study included 200 coronary artery disease patients who underwent isolated off-pump coronary artery bypass grafting (OPCAB) at the National Heart Foundation Hospital and Research Institute between January 2019 and June 2020. Patients were categorized into Group 1, with a left ventricular ejection fraction (LVEF) of 30% - 39%, and Group 2, with an LVEF of 40% or higher. Echocardiographic assessments of left ventricular dimensions and ejection fraction were performed preoperatively, at discharge, and one month postoperatively. Results: In Group 1, preoperative left ventricular internal dimensions during diastole (LVIDd) and systole (LVIDs) were 53.48 ± 4.40 mm and 44.23 ± 3.93 mm, respectively, with a left ventricular ejection fraction (LVEF) of 35.28% ± 2.26%. At discharge, these values improved to 51.58 ± 4.04 mm (LVIDd), 41.23 ± 5.30 mm (LVIDs), and 39.25% ± 3.75% (LVEF). One month postoperatively, further improvements were observed: 46.29 ± 3.76 mm (LVIDd), 37.45 ± 3.68 mm (LVIDs), and 43.22% ± 4.67% (LVEF). Group 2 showed similar positive outcomes, with preoperative values of 47.09 ± 5.06 mm (LVIDd), 35.11 ± 5.25 mm (LVIDs), and 50.13% ± 7.25% (LVEF), improving to 42.37 ± 4.18 mm (LVIDd), 31.05 ± 4.19 mm (LVIDs), and 55.33% ± 7.05% (LVEF) at one month postoperatively. Both groups demonstrated significant improvements in left ventricular function and NYHA class, with most patients moving from class III/IV to I/II. Complications were minimal, and no mortality was observed. Conclusion: OPCAB is safe and effective for patients with LVEF 30% - 39% and LVEF ≥ 40%, providing significant short-term functional improvements without increased risk.
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Abdullah et al. (2024) conducted a cross-sectional in Coronary artery disease with left ventricular dysfunction (n=200). Off-pump coronary artery bypass grafting (OPCAB) in patients with LVEF 30%-39% vs. OPCAB in patients with LVEF ≥ 40% was evaluated on Left ventricular ejection fraction (LVEF) at 1 month postoperatively (p=<0.001). Off-pump coronary artery bypass grafting significantly improved left ventricular ejection fraction from 35.28% to 43.22% at one month in patients with preoperative ejection fractions of 30-39%.
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