Objective and background - This study evaluated the outcome of CABG in patients with advanced left ventricular dysfunction (EF<35%) with diffuse CAD, in terms of the change in their LV ejection fraction and the functional status postoperatively, since such a subset is regarded as high risk with poor outcome. Material and method- A total of 100 patients, of Coronary Artery Disease with diffusely diseased vessels and severe LV dysfunction, who underwent Coronary Artery Bypass Grafting in our center between 2010 and 2016, were included in this study. This study was an ambispective observational study. Patients were evaluated and analyzed retrospectively as well as prospectively followed up. Statistical analysis done using statistical software STATA 13 IC. Results - In our study group (N=100), 81 (81%) underwent on pump CABG, while 19, (19%) underwent off pump CABG with mean of 3.62 distal graft per patient. The intraoperative and the postoperative follow up data at 03, 06, and at the 12 month with median follow up period of 09 months, revealed that the improvement in mean LVEF (%) from 28.6% (SD= 2.8) to 37.3% (SD= 7) intraoperatively to 41.5(SD= 8.3)(Range : 20-55), at one year follow up, with p value of <0.001, which is statistically very significant. There is also a significant improvement in the NYHA Class in the study population. Preoperatively, 82, (82%) patients in the study group were in NYHA Class 3B, and 18(18%) were in class 2B However at 06 month postoperative follow up, 79, (81.4%) of the study population functionally improved to, class 1B, with p value of <0.001, which is statistically very significant. Conclusion -The outcome of this study shows definite improvement in the LVEF and in the NYHA class and suggests that, CABG in this setting of the patients is effective, safe and should be recommended.
Impact Factor
2022: 6.012
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