The 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.

Abstract

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.