title: Long-term outcomes after off-pump coronary artery bypass grafting in left ventricular dysfunction.
abstract: OBJECTIVE
  We assessed the long-term clinical, angiographic, and echocardiographic outcomes of patients with left ventricular dysfunction (ejection fraction ≤40%) who underwent isolated off-pump coronary artery bypass grafting.
  
  
  METHODS
  One hundred sixty one patients were included. Mean age was 67.2 ± 11.4 years, and 20 patients (12.4%) were female. Eighty-eight patients (54.7%) were New York Heart Association functional class 3 or 4. Early postoperative and follow-up angiography and echocardiography findings were analyzed, and mid-term survival rates (mean follow-up 40.7 ± 25.6 months) were calculated.
  
  
  RESULTS
  Mean number of distal anastomoses was 4.4 ± 1.3. Bilateral internal thoracic artery grafts were used in 84.5% of patients. Operative mortality was 2.5%. Early patency rate of anastomoses was 98.3%. Early postoperative ejection fraction improved from 33.1 ± 5.6% preoperatively to 36.9 ± 9.5% (p <0.001). Seven-year survival rate was 73.9 ± 5.3%, and freedom from cardiac events rate was 68.5 ± 5.2%. One-year patency rate of anastomoses was 85.8%. Follow-up ejection fraction was 39.1 ± 10.7% (p <0.001).
  
  
  CONCLUSIONS
  Early and long-term outcomes of off-pump coronary artery bypass grafting in patients with left ventricular dysfunction were favorable, including early postoperative and follow-up patency rates of anastomoses and echocardiographic recovery of ejection fraction.
authors.affiliation: Department of Cardiovascular Surgery, Sakakibara Heart Institute.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Fukui
authors.forename: Minoru
authors.initials: M
authors.lastname: Tabata
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Takanashi
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects / Q000401:mortality; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D014654:Vascular Patency; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology*; D016277:Ventricular Function, Left