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Predictors of Outcome After Coronary Bypass Surgery in Patients with Left Ventricular Dysfunction [Anatol J Cardiol]
Anatol J Cardiol. 2002; 2(1): 26-34

Predictors of Outcome After Coronary Bypass Surgery in Patients with Left Ventricular Dysfunction

Fatih İslamoğlu1, Anıl Z. Apaydın2, Mustafa Özbaran2, Münevver Yüksel1, Ali Telli1, İsa Durmaz1
1Department of Cardiovascular Surgery, Ege University Medical Faculty, İzmir
2Ege Üniversitesi Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, İzmir

Objective: The aim of this study was to determine the risk factors affecting the mortality and morbidity after coronary artery bypass grafting (CABG) in patients with LV dysfunction and without any viability assessment. Methods: The preoperative, perioperative, and postoperative early and mid-term follow-up data of 252 patients with left ventricular ejection fraction (LVEF) of £30% who underwent isolated CABG from 1995 through 2000, were evaluated. No preoperative viability study was performed for patient selection. Preoperative echocardiography and cardiac catheterization, and postoperative control echocardiography were performed in all patients. Follow-up data after the discharge of these patients were obtained via monthly periodical examinations in the first 6 months, and thereafter via telephone interviews. As preoperatively, 229 (90.87%) patients were in NYHA class III or IV, and the mean LVEF was 26.58±3.66%. Results: Overall mortality and late mortality rates were 16.27% and 5.16%, respectively. Postoperative complications were observed in 61 (24.21%) patients. During 49.06±15.17 months of follow-up, 185 (93.43%) of 198 (78.57%) survived patients were in NYHA class I or II and the mean LVEF was 39.64%±5.68%. Advanced age, diabetes, hypertension, cross-clamp time >60 min, bypass time>120 min, severity of angina and functional classes (class III-IV of NYHA and CCS) were found to be the determinants of mortality. However, by multivariate analysis only older age and class III-IV of NYHA and CCS were detected as predictors of mortality. Conclusion: The low mortality and morbidity rates as well as postoperative improvements in functional capacity and in LVEF support the use of CABG without the need of any viability assessment in patients with left ventricular dysfunction. Advanced age, severe angina and functional symptom status seem to be the predictors of poor prognosis in these patients after CABG.

Keywords: Coronary artery bypass, left ventricular dysfunction, risk factors

Fatih İslamoğlu, Anıl Z. Apaydın, Mustafa Özbaran, Münevver Yüksel, Ali Telli, İsa Durmaz. Predictors of Outcome After Coronary Bypass Surgery in Patients with Left Ventricular Dysfunction. Anatol J Cardiol. 2002; 2(1): 26-34

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