Coronary artery bypass grafting in patients with low ejection fraction: the effect of intra-aortic balloon pump insertion on early outcome.
BACKGROUND
Survival benefit with intra-aortic balloon pump (IABP) insertion for coronary artery bypass grafting (CABG) patients with left ventricular dysfunction is controversial. The aim of this study was to assess the early results of CABG that predict 30-day mortality and prolonged length of hospital stay (LOS) after isolated CABG and the role of IABP application as a main predictor in patients with an ejection fraction (EF) of 30% or less.


METHODS
Eight hundred and thirty-three patients who underwent isolated CABG with EF < or = 30% were entered and compared with 10881 patients with EF > 30% as the control group. Demographic and clinical characteristics and postoperative complications were considered. Data were analyzed using the student's t-test and chi-square test for univariate analysis and the analysis of covariance and logistic regression for multivariate analysis.


RESULTS
The thirty-day mortality rate (1.6% vs. 0.7%, P P P = 0.002) and prolonged LOS (P = 0.009). Also, urinary tract infection, prolonged ventilation, and renal failure as postoperative complications were statistically more in the group with the application of IABP.


CONCLUSIONS
Low ejection fraction can positively affect thirty-day mortality and prolonged LOS and ICU stay in patients who undergo CABG. In these patients, IABP insertion is a strong predictor for early complication and mortality.
Davoodi
Saeed
S
Department of Cardiac Surgery, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. davoodi@tehranheartcenter.org
Karimi
Abbasali
A
Ahmadi
Seyed Hossein
SH
Marzban
Mehrab
M
Movahhedi
Namvar
N
Abbasi
Kyomars
K
Omran
Abbas Salehi
AS
Shirzad
Mahmood
M
Sheikhvatan
Mehrdad
M
Abbasi
Seyed Hesameddin
SH
D000704:Analysis of Variance; D016022:Case-Control Studies; D001026:Coronary Artery Bypass / Q000401:mortality; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007423:Intra-Aortic Balloon Pumping / Q000401:mortality; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012372:ROC Curve; D012307:Risk Factors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000401:mortality / Q000601:surgery*