Key result
Elective coronary artery bypass grafting in patients with left ventricular dysfunction improved mean LVEF from 38.8% to 43.3% and was associated with a 5% hospital mortality.
Why the study?
Coronary artery bypass grafting in patients with left ventricular dysfunction remains a surgical challenge and is still controversial.
Does elective isolated CABG improve left ventricular systolic function and survival in patients with left ventricular dysfunction (LVEF ≤ 45%)?
Observational (n=160)
Does elective isolated CABG improve left ventricular systolic function and survival in patients with left ventricular dysfunction (LVEF ≤ 45%)?
Elective isolated CABG in patients with left ventricular dysfunction (LVEF ≤ 45%) is associated with acceptable mortality and significant improvement in postoperative left ventricular systolic function.
Answers are grounded in this paper and cite their sources.
Supports elective CABG for LVEF gains with acceptable mortality in LV dysfunction; leaves open causal benefits pending randomized confirmation.
INTRODUCTION: Coronary artery bypass grafting (CABG) in patients with left ventricular dysfunction (LVD) remains a surgical challenge and is still controversial. The aim of this study was to evaluate the effectiveness of CABG in patients with LVD. METHODS: This retrospective study included a total of 160 consecutive patients (133 males, 27 females, mean age 62.1±10.12 years [range 37 to 86 years]) who had a left ventricular ejection fraction (LVEF) ≤ 45% determined by echocardiography and underwent elective isolated CABG between September 2013 and December 2018. Preoperative echocardiographic data, such as ejection fraction, left ventricular (LV) end-systolic diameter, and LV end-diastolic diameter, were collected and evaluated. Preoperatively, 85 (53.13%) patients were in New York Heart Association functional class III or IV and the mean LVEF was 38.65±5.72% (range 20 to 45). RESULTS: The overall hospital mortality was 5% (eight patients). Late follow-up was obtained in 152 (90%) cases (median follow-up time was 56,5 [3-87] months postoperatively). During follow-up, mortality developed in 11.3% (16 patients). Mean LVEF increased significantly from 38.78±5.59% before surgery to 43.29±8.46% after surgery (P<0.01). Mean late survival, freedom from coronary reintervention, and congestive heart failure rates were 86.3±3.3%, 88.7±3.9%, and 89.4±3.1%, respectively. CONCLUSION: In patients with LVD, CABG can be performed with low postoperative morbidity and mortality rates. Patients with LVD could benefit from coronary bypass surgery regarding postoperative LV systolic function and higher quality of life.
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Salihi et al. (2022) conducted an observational in Left ventricular dysfunction (n=160). Coronary artery bypass grafting (CABG) vs. Preoperative baseline was evaluated on Mean LVEF (p=<0.01). Elective coronary artery bypass grafting in patients with left ventricular dysfunction improved mean LVEF from 38.8% to 43.3% and was associated with a 5% hospital mortality.
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