Left ventricular function outcome after coronary artery bypass grafting, King Abdullah Medical City (KAMC)- single-center experience

Khaled, Sheeren; Kasem, Ehab; Fadel, Ahmed; AlZahrani, Yasmeen M.; Banjar, Khadijah Salem M; Al-Zahrani, Wafa’a; Alsulami, Hajar; Allhyani, Mazad Ali

doi:10.1186/s43044-019-0002-6

Cited by 10 publications

(13 citation statements)

References 31 publications

(27 reference statements)

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“…A male predominance was noticed (N = 138, 94.52%). The same results were seen in recent studies like Jose et al and Khalid et al [Jose 2019;Khaled 2019]. In Jose et al, it was 58.67 (9.70) years, and Khalid et al reported the same was 56.1 (12.2) years.…”

Section: Discussionsupporting

confidence: 86%

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Outcomes of Coronary Artery Disease Patients with Severe Left Ventricular Dysfunction Undergoing Surgical Management

Ponnuru

Radhakrishnan

Sudevan

et al. 2022

HSF

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Background: Surgical revascularization by coronary artery bypass grafting (CABG) is the gold standard treatment for coronary artery disease. But, in patients with severe left ventricular dysfunction (ischemic cardiomyopathy), the result of CABG is different from those with normal left ventricular function. The coronary artery disease pattern in the Indian subconti-nent is different from the western world, due to the diffuse nature of coronary involvement, the smaller size of native vessels, increased prevalence of diabetes mellitus and other risk factors, and more prevalence of severe left ventricular dysfunction. Most of the studies regarding the surgical outcomes in ischemic cardiomyopathy come from western countries. This study attempts to assess the outcomes of surgical management of ischemic cardiomyopathy in the Indian subcontinent. Methods: A single-center retrospective cohort study was conducted at Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram. The data of CAD pa-tients, who underwent surgical coronary revascularization for severe LV dysfunction from January 2010 to December 2014, were collected from the hospital records and through tele-phonic interviews in a structured study proforma. A total of 146 patients satisfied the criteria and were followed up for a period of 5 years. Results: The mean age of the study population was 55.6 (8.8) years. Male preponderance was observed (94.52%; N = 138). CABG alone was done in 62.3% (N = 91) of the study partici-pants. CABG with linear plication was done in 23.3% (N = 34), CABG with MV repair in 7.5% (N = 11), and CABG with DORS in 6.8% (N = 10). The majority of patients (N = 54, 37%) received 4 grafts. Thirty-day mortality observed in the study population was 11 (7.5%). The causes documented were cardiac causes in 9 (82%), cerebrovascular events in one (9%), and septicemia in one (9%). The mean of 5-year survival of the study population was 94.2 (3.5) months with 95% CI 87.32, 101.13. There was a substantial improvement in the degree of mitral regurgitation. Ejection fraction (EF) also showed improvement. The mean preoperative EF was 29.51 (4.84%) and that of post-op was 39.92 (9.0%). Conclusion: Despite the challenges of diffusely diseased coronary arteries, severe LV dysfunction, addressing associated significant MR and ventricular aneurysms, the outcome of surgical management of CAD with severe LV dysfunction, in the Indian population can be done with acceptable results. Randomized control studies in this subset can provide more solid evidence in this regard.

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Section: Discussionsupporting

confidence: 86%

“…Several studies worldwide have proven the relevance of CABG in left ventricular dysfunction [Jose 2019;Khaled 2019;Ngu 2018]. In ischemic cardiomyopathy, surgical revascularization helps to conserve the viable myocardium, reduce the ischemia, and help restore LV function.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Coronary Artery Disease Patients with Severe Left Ventricular Dysfunction Undergoing Surgical Management

Ponnuru

Radhakrishnan

Sudevan

et al. 2022

HSF

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“…Cardiac surgery outcomes improved in the past few years, and the current scoring systems are prone to overestimate poor outcomes. 12 Khaled et al 13 reported that CABG patients with low LVEF had acceptable mortality of 5.4%. Another study by Elassy et al 14 also found that LVEF < 35% was not a significant predictor of mortality.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Low Preoperative Ejection Fraction on Mortality After Cardiac Surgery in Indonesia

Kurniawaty¹,

Setianto²,

Supomo³

et al. 2022

VHRM

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“…Complete revascularization is defined as an intervention targeting all stenotic coronary vessels with a diameter greater than >1.5mm and >50% lumen narrowing in at least one angiographic view and can be done with either percutaneous coronary intervention or CABG [Ong 2006]. Several studies support the role of CABG in improving EF in this patient category [Khaled 2019;Koene 2017].…”

Section: Discussionmentioning

confidence: 99%

“…The patients were classified into two groups: group I, 76 (69%) patients with EF > 35%, and group II, 34 (31%) patients with EF < 35%. Both groups had a significant postoperative EF increase with an average EF of 29.76 ± 4.868 pre-CABG to 33.53 ± 9.655 postoperative (P < 0.05) [Khaled 2019]. This increase in EF is perhaps due to revascularization of hibernating myocardium caused by chronic low blood flow circulating the myocardium [Kloner 2020].…”

Section: Discussionmentioning

confidence: 99%

Complete Revascularization Showed A Better Cardiac Function Improvement In Patients With Low Ejection Fraction

Soetisna

Nugraha

Rokim

et al. 2022

HSF

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Purpose: This study aimed to compare postoperative ejection fraction (EF) in response to coronary artery bypass grafting (CABG) among patients with preoperative EF <35% and >35%. Methods: A retrospective study was conducted in a single institution using clinical data of 660 patients undergoing elective on-pump CABG in 2018-2019. Patients were classified into two groups based on preoperative left ventricle ejection fraction (<35% and >35%). The primary endpoint was the change of postoperative ejection fraction. Results: In this study, 72 patients had preoperative left ventricle ejection fraction <35% (group A) while the other 588 patients had ejection fraction >35% (group B). Among both groups, the duration of cardiopulmonary bypass (CPB) and aortic clamp (AxC) were not significantly different (P > 0.05). The transformation of pre- and postoperative EF in groups A and B was significantly different (2.91+10.31 vs. -0.14+4.57, P < 0.001). There was a significant difference in the duration of ICU stay (73.42+112.55 vs. 34.43+64.99, P < 0.001) and postoperative ventilatory support (25.54+43.92 vs. 16.42+45.87, P < 0.008) between group A and B. Conclusion: Low preoperative EF showed better improvement in cardiac function after surgery. We concluded that the result could be affected by revascularization of hibernating myocardium.

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Left ventricular function outcome after coronary artery bypass grafting, King Abdullah Medical City (KAMC)- single-center experience

Cited by 10 publications

References 31 publications

Outcomes of Coronary Artery Disease Patients with Severe Left Ventricular Dysfunction Undergoing Surgical Management

Outcomes of Coronary Artery Disease Patients with Severe Left Ventricular Dysfunction Undergoing Surgical Management

The Effect of Low Preoperative Ejection Fraction on Mortality After Cardiac Surgery in Indonesia

Complete Revascularization Showed A Better Cardiac Function Improvement In Patients With Low Ejection Fraction

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