title: Off-pump coronary artery bypass surgery in severe left ventricular dysfunction.
abstract: Our aim was to examine hospital outcomes of coronary artery bypass surgery in patients with and without left ventricular dysfunction, with regard to the surgical technique (off- or on-pump). Between March 2007 and March 2008, 689 consecutive patients underwent isolated first-time coronary artery bypass; 127 had ejection fractions < or = 30% (group 1) and 562 had ejection fractions >30% (group 2). Data of preoperative risk profiles and hospital outcomes were collected prospectively. Off-pump operations were performed in 49 (38.6%) patients in group 1 and 196 (34.9%) in group 2. The incidences of infectious, neurologic, and cardiac complications postoperatively were significantly higher in group 1. In multivariate analysis, preoperative ejection fraction < or = 30% was found to be an independent risk factor for postoperative complications and hospital mortality. The subgroup of patients undergoing off-pump surgery in both groups had a significantly lower rate of total complications than those undergoing conventional on-pump operations, but no significant difference in mortality was observed between those undergoing off-pump or conventional surgery in either group. Off-pump surgery helped to limit the increased morbidity rate after coronary bypass in patients with ventricular dysfunction.
authors.affiliation: Cardiovascular Research Center, Madani Heart Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Rasoul
authors.initials: R
authors.lastname: Azarfarin
authors.forename: Leili
authors.initials: L
authors.lastname: Pourafkari
authors.forename: Rezayat
authors.initials: R
authors.lastname: Parvizi
authors.forename: Azin
authors.initials: A
authors.lastname: Alizadehasl
authors.forename: Roghaiyeh
authors.initials: R
authors.lastname: Mahmoodian
mesh_terms: D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006352:Heart Ventricles / Q000601:surgery; D017052:Hospital Mortality; D006801:Humans; D007492:Iran; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000601:surgery*