Outcomes of Off-Pump Coronary Bypass Grafting with the Bilateral Internal Thoracic Artery for Left Ventricular Dysfunction

• Published in: Journal of Korean medical science Vol. 29; no. 1; pp. 69 - 75
• Main Authors: Chung, Suryeun, Kim, Wook Sung, Jeong, Dong Seop, Lee, Jaejin, Lee, Young Tak
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Medical Sciences 01.01.2014; 대한의학회
• Subjects: Coronary Artery Bypass, Off-Pump - methods; Coronary Artery Bypass, Off-Pump - mortality; Female; Heart; Humans; Male; Mammary Arteries - transplantation; Middle Aged; Original; Retrospective Studies; Stroke Volume; Survival Rate; Treatment Outcome; Vascular Grafting - methods; Vascular Grafting - mortality; Ventricular Dysfunction, Left - mortality; Ventricular Dysfunction, Left - surgery; Ventricular Function, Left; 의학일반; Coronary Artery Bypass, Off-Pump; Ventricular Dysfunction; Internal Mammary Artery
• ISSN: 1011-8934; 1598-6357; 1598-6357
• DOI: 10.3346/jkms.2014.29.1.69

This study evaluated the outcomes of off-pump coronary artery bypass surgery (OPCAB) with severe left ventricular dysfunction using composite bilateral internal thoracic artery grafting. From January 2001 to December 2008, 1,842 patients underwent primary isolated OPCAB with composite bilateral internal thoracic artery grafting. A total of 131 of these patients were diagnosed with a severely depressed preoperative left ventricle ejection fraction (LVEF) (≤ 0.35). These patient outcomes were compared with the outcomes of 830 patients that had mildly or moderately depressed LVEF (0.36 to 0.59) and 881 patients with normal LVEF (>0.6). The early mortality for patients with severe LVEF was 2.3%. The 3-yr and 7-yr survival rate for patients with severe LV dysfunction was 86.0% and 82.8%, respectively. Multivariate analysis showed that severe LV dysfunction EF increased the risk of all-cause death (P=0.012; hazard ratio [HR],2.14; 95% confidence interval [CI],1.19-3.88) and the risk of cardiac-related death (P=0.008; HR,3.38; 95% CI, 1.37-8.341). The study identified positive surgical outcomes of OPCAB, although severe LVEF was associated with two-fold increase in mortality risk compared with patients who had normal LVEF.