Abstract:
Objectives: Despite great advances in surgeries, the management
of patients with impaired left ventricular ejection fraction is still
challenging. Furthermore, evidences on outcomes of off-pump coronary
artery bypass surgery (OPCAB) in this population are inconsistent. We
conducted present study to compare the short and long-term outcomes in
patients with different ejection fractions undertaken OPCAB.
Methods: This retrospective cohort used data from the HuaShan
Cardiac-surgery Registry and included the consecutive patients aged ≥ 18
years who were underwent OPCAB procedures during 2007-2019. Patients
included in the study were followed until death or the end of data
collection. Patients with different ejection fractions were matched 1:2
using propensity score matching. Factors associated with short-term
outcomes were determined using logistic regression and Kaplan-Meier
survival analyses for the differences of all-causes death were
generated.
Results: The 2 propensity score-matched groups consisted of 40
LVD (left ventricular dysfunction) and 120 NLVF (normal left ventricular
function) patients, respectively. There were no statistical differences
in the postoperative outcomes between groups except for the occurrence
of left heart failure (22.5% in LVD vs. 5.0% in NLVF, p =0.009).
Age (OR=1.11, 95%CI: 1.04-1.18) but not the preoperative left
ventricular ejection fraction was shown in logistic regression to be a
strong predictor of experiencing short-term events. Kaplan-Meier curves
displayed a similar freedom from all cause death (p =0.119) or
cardio-death (p =0.092) between groups.
Conclusion: The immediately outcomes post-operation and the long-term
outcomes between groups are similar, indicating that OPCAB is a safe and
effective choice for left ventricular dysfunction patients.