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.