title: Coronary surgery in patients with low ejection fraction: mid-term results.
abstract: BACKGROUND
  The aim of this study was to investigate the effect of preoperative low ejection fraction (≤30%) on postoperative morbidity and mortality in patients undergoing isolated on-pump coronary artery bypass grafting. We also investigated the effect of pre- and perioperative factors on survival.
  
  
  METHODS
  Between January 2002 and December 2009, 103 (6.2%) patients with an ejection fraction ≤30% and 1554 (93.8%) with an ejection fraction >30% underwent coronary artery bypass grafting.
  
  
  RESULTS
  In multivariate logistic regression analysis, cardiopulmonary bypass time, operation time, prolonged inotropic support, and intensive care unit stay were independent predictors of mortality in patients with low ejection fraction. Intensive care unit and hospital stays were significantly longer in these patients, and the postoperative mortality rate was significantly higher. Advanced age (≥70 years) influenced mortality during the follow-up of patients with low ejection fraction. Midterm survival was significantly reduced in patients with ejection fraction ≤30%. Smoking, prolonged inotropic support, and prolonged ventilatory support were independent predictors of midterm survival in patients with ejection fraction ≤30%.
  
  
  CONCLUSIONS
  On-pump coronary artery bypass grafting can be performed in patients with ejection fraction ≤30%, with reasonable mortality and morbidity rates.
authors.affiliation: Department of Cardiovascular Surgery, İzmir Atatürk Training and Research Hospital, Izmir, Turkey.
authors.forename: Kazim
authors.initials: K
authors.lastname: Ergünes
authors.forename: Ismail
authors.initials: I
authors.lastname: Yurekli
authors.forename: Banu
authors.initials: B
authors.lastname: Lafci
authors.forename: Orhan
authors.initials: O
authors.lastname: Gokalp
authors.forename: Muhammed
authors.initials: M
authors.lastname: Akyuz
authors.forename: Ufuk
authors.initials: U
authors.lastname: Yetkin
authors.forename: Levent
authors.initials: L
authors.lastname: Yilik
authors.forename: Ali
authors.initials: A
authors.lastname: Gurbuz
mesh_terms: D000367:Age Factors; D000368:Aged; D002315:Cardiopulmonary Bypass; D002316:Cardiotonic Agents / Q000627:therapeutic use; D016009:Chi-Square Distribution; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D061646:Operative Time; D016016:Proportional Hazards Models; D012121:Respiration, Artificial; D012307:Risk Factors; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology*; D016277:Ventricular Function, Left
chemical_list: D002316:Cardiotonic Agents
keywords: Coronary artery bypass; postoperative complications; risk factors; survival rate; ventricular dysfunction