Off-Pump Coronary Artery Bypass in Severe Left Ventricular Dysfunction

Abstract

The outcome of multivessel off-pump coronary artery bypass grafting in cases of severe left ventricular dysfunction was studied in 58 consecutive patients with ejection fraction < or =35% who were followed up for a median of 15 months. Patients with ejection fractions < or =25% (group 1) had the largest left ventricular dimensions preoperatively, with gradual increases during follow-up; those with ejection fractions of 26%-35% (group 2) had smaller preoperative ventricular dimensions, with left ventricular regression postoperatively. There was more improvement in ejection fraction in group 2 than group 1 (33% vs. 10%). Mitral regurgitation improved from moderate to mild in group 2; whereas in group 1, mild mitral regurgitation progressed to moderate or severe during follow-up. Ejection fraction was a predictor of more frequent use of intraaortic balloon pumping, longer duration of inotropic use, a higher mean pulmonary artery-to-systemic arterial pressure ratio, and increased postoperative drainage.

Differential release kinetics of cardiac biomarkers in off-pump coronary bypass

“…Stabilization of the heart was achieved with pericardial hitch stitches and a stabilizer, as we described previously. 12 Levels of the biomarkers (BNP, TnI, and CK-MB) were measured 24 h before surgery and serially at 6, 24, 48 h, and 1 month after surgery. The measurements were carried out by fluorescence immunoassay using a commercially available kit (Alere Triage Cardio 3 Panel; Alere San Diego, Inc., San Diego, CA, USA).…”

Postoperative atrial fibrillation in coronary artery bypass grafting herald poor outcome

“…All the patients were operated using off-pump coronary artery bypass grafting technique. [ 9 ] They received total arterial revascularization using both internal mammary arteries.…”

Effect of coronary artery bypass grafting on function of right ventricle in patients with severe left ventricular dysfunction

“…Deep pericardial stay sutures are used for positioning of the heart as described in detail by author previously. 12 Pulmonary artery pressure and cardiac index are calculated in all cases. Cardiac index is calculated pre-induction followed by postinduction and following every graft 3 min after the heart is returned back to the pericardial cradle from its position for performing that graft.…”