Open AccessThe Influence of Left Ventricular Dysfunction on The Early and Midterm Outcome in The Patients Undergoing Off Pump Coronary Artery Bypass Grafting Assessed by Propensity Matched Score Analysis
Author(s) -
Tomonori Shirasaka,
Nuttapon Arayawudhikul,
Apichat Tantraworasin,
Angsu Chartrungsan,
Boonsap Sakboon,
Jaroen Cheewinmethasiri,
Hiroyuki Kamiya
Publication year - 2022
Publication title -
the heart surgery forum/the heart surgery forum
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.255
H-Index - 38
eISSN - 1522-6662
pISSN - 1098-3511
DOI - 10.1532/hsf.4311
Subject(s) - medicine , ejection fraction , off pump coronary artery bypass , cohort , artery , cardiology , propensity score matching , risk factor , bypass grafting , creatinine , surgery , heart failure
Background: It still remains unclear the depth of influence of left ventricular dysfunction on the recovery of patients’ physical conditions in the early and midterm period following off-pump coronary artery bypass grafting (OPCAB).Methods: From April 2011 to May 2018, 851 patients underwent OPCAB in our center. All were grouped into two groups: Those whose ejection fraction (EF) was under 35% were defined as the Low EF group (N = 158) and those who maintained EF over 35% were defined as the Faired EF group (N = 693). Preoperatively, there was significant difference in NYHA class (P < 0.001), CCS class (P = 0.038), level of creatinine (P < 0.001), and rate of establishment of IABP (P < 0.001).Results: Regarding all-cause death in the early postoperative period, low EF was a not a risk factor in patients (P = 0.52) or in the matched cohort (P = 0.398); however, in the midterm, it was a significant risk factor in patients (HR 2.07, P = 0.016) and in the matched cohort (HR 2.72, P = 0.029). Overall survival at 5 years in the Low EF group was significantly inferior to that of the Faired EF group in all (67.4±4.1% and 86.1±2.9%, P = 0.001) and in the matched cohort (66.5±6.4% vs. 86.5±4.5%, P = 0.008).Conclusion: OPCAB seems beneficial for patients with LV dysfunction considering the early outcome, however, low EF is a significant risk factor for overall death in the midterm period.