The influence of a low ejection fraction on long-term survival in systematic off-pump coronary artery bypass surgery

Maltais, Simon; Ladouceur, Martin; Cartier, Raymond

doi:10.1016/j.ejcts.2010.12.022

Cited by 10 publications

(8 citation statements)

References 26 publications

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“…Carmelo et al declared that female gender was associated with the need for surgery that is similar to the results of this study (P=0.000) (15). Simon Maltais et al demonstrated that the average age was not significant that it is in line with the findings of the present study (P=0.454) (16). Kazim et al reported in patients with EF below 30% the use of IABP is significant (P= 0.000); however, there was no difference between the number of patients' graft with EF below 30% and EF above 30% (P= 0.957) that are comparable with this study (P=0.863).…”

Section: Discussionsupporting

confidence: 91%

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A survival after coronary artery bypass grafting surgery with ejection fraction below 30 percent

2018

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Introduction: Regarding the progress in surgeries, the mortality rate of coronary artery bypass grafting surgery is still low, despite advanced age and comorbidities. One of the independent causes of mortality rate is low ejection fraction (EF). This study aimed to assess mortality after coronary artery bypass grafting (CABG) operation in patients with ejection fraction under 30%. In the present study the experience of 20 patients with an EFbelow 30% and 20 patients with an EF above 30% was investigated in Birjand in which only three of the patients died within 2 years after the operation. Methods: This crross-sectional descriptive study was conducted on 40 patients in Birjand Vali-e-aser Hospital. Out of the 40 cases, 20 patients had EF below 30% and 20 subjects had EF above 30 %. The files of all the cases undergoing heart surgery with an EF were obtained since 2015 to 2017, and then their demographic features, such as addresses and phone numbers were collected. Afterwards, they were called and their mortality was checked and the data were analyzed with independent-samples t-test. In addition, the ratios were examined in SPSS Software (version 22) and P-value considered higher than 0.05. Results: From 2015 to 2017, the two groups, including 20 patients with EF<30% and 20 patients with EF>30%, undergone CABG surgery in Birjand University of Medical Science, 65% of which were men and 35 % were women with the age range of 64.7 for the cases with EF<30 and 62.5 for the subjects EF>30. One of the patients died with an EF above 30% and two subjects died with EF below 30%. Conclusions: The mortality rate can be reduced with providing appropriate care despite the fact that an EF<30% is an independent cause of mortality and according to the results of the present study which showed three patients died after the CABG operation.

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Section: Discussionsupporting

confidence: 91%

“…In the present study, renal failure in patients was 2.5%, which was less than that in a study by Maltais S et al (16). Moreover, according to our results addiction was related with mortality after CABG surgery (0.002).…”

Section: Discussioncontrasting

confidence: 59%

A survival after coronary artery bypass grafting surgery with ejection fraction below 30 percent

2018

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“…Reduced LVEF is an established risk factor for perioperative complications and mortality after CABG [ 8 , 25 ]. Although recent studies indicate that off-pump CABG may be associated with benefits compared to on-pump CABG in reduced LVEF patients [ 26 , 27 ], all-cause and cardiovascular mortality was increased in this subset of patients [ 27 ]. In our cohort, LVEF ≤ 45% increased the risk of long-term mortality three-fold.…”

Section: Discussionmentioning

confidence: 99%

A Risk Score for Predicting Long-Term Mortality Following Off-Pump Coronary Artery Bypass Grafting

Urbanowicz

Michalak

Olasińska-Wiśniewska

et al. 2021

JCM

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Background: Off-pump coronary artery bypass grafting (OPCAB) comprises 15–30% of all bypass grafting surgeries. The currently available perioperative scores such as Euroscore and STS score do not specifically predict long-term mortality after off-pump procedures. The neutrophil-to-lymphocyte ratio (NLR) is one of the new, easily accessible markers of inflammation with proven predictive value in cardiovascular diseases. We aimed to develop the first risk score for long-term mortality after OPCAB and to determine if the perioperative value of NLR predicts long-term mortality in OPCAB patients. Methods: In total, 440 consecutive patients with multivessel stable coronary artery disease undergoing OPCAB were recruited. Differential leukocyte counts were obtained by a routine hematology analyzer. Data regarding mortality during a median follow-up time of 5.3 years were obtained from the Polish National Health Service database. An independent population of 242 patients served as a validation cohort. Results: All-cause mortality was influenced by different clinical risk factors. In multivariate regression analysis, chronic obstructive pulmonary disease, stroke history, post-operative NLR and LVEF were independent predictors of mortality. Combing all independent predictors predicted long-term all-cause mortality with 68.5% sensitivity and 71.5% specificity (AUC = 0.704, p < 0.001). After weighing these variables according to their estimates in a multivariate regression model, we developed a score to predict mortality in patients undergoing OPCAB (PREDICT-OPCAB Score, ranging from 0 to 10). Patients with a high score were at higher risk of mortality within the median 5.3 years of follow-up (score 0–3: 8.3%; 4–6: 27.0%; 7–10: 40.0%; p < 0.001 for score 0–3 vs. 4–6 and 7–10). This association was confirmed in the validation cohort. Conclusions: We developed and validated the first simplified risk score to predict mortality following OPCAB based on easily accessible clinical factors. This risk score can be used when obtaining a patient’s informed consent and as an aid in determining treatment.

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“…Cardiovascular surgeons have encountered more patients with left ventricle dysfunction recently because of increased number of coronary artery interventions [3]. It was of increased interest for surgical treatment of ischemic cardiomyopathy because of limited donor candidates for transplantation.…”

Section: Discussionmentioning

confidence: 99%

Levosimendan usage in patients with left ventricle dysfunction in coronary artery bypass graft surgery

Cakir¹,

Tor²,

Uncu³

et al. 2012

WJCD

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Introduction: In this study we explicated early results of patients (the patients in whom levosimendan was used) who underwent coronary artery bypass graft surgery with ejection fraction 35% or less. We compared this group with the patients in whom levo-simendan was not used. Material and Methods: 97 patients who have 35% ejection fraction or less taken to isolated coronary artery bypass surgery between January 2009 and December 2011 in our clinic are chosen for this study retrospectively. We compared the patients in whom levosimendan was used with the patients in whom levosimendan was not used. Levo- simendan (Simdax, Abbott) has been used according to surgeon’s decision in patients. Results: The mean age of group 1 was 62.3 ± 7.6, and the mean age of group 2 was 59.3 ± 10.5 (p > 0.05). It was detected that the average ejection fraction was less in group 1 (p < 0.05). There were no statistically significant difference between the two groups in terms of demand for inotropics, demand for intraaortic balloon pump, revision (because of bleeding), atrial fibrillation, discharging intervals, intensive care unit time, cross clamp and cardiopulmonary bypass time (p > 0.05). It was found that need for blood transfusion were less in group 1 than group 2 (p < 0.05). There were no statistically significant difference between the two groups in terms of mortality (p > 0.05). Conclusion: We consider levosimendan reduces need for blood transfusion in coronary artery bypass graft surgery. This results may change with increasing number of patients so we consider that multicenter larger study is needed

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The influence of a low ejection fraction on long-term survival in systematic off-pump coronary artery bypass surgery

Abstract: Off-pump coronary artery bypass surgery can be performed adequately and safely in poor EF patients. However, overall and cardiac survival was decreased in this subset of patients with a comparable freedom from major cardiac adverse related events.

Cited by 10 publications

References 26 publications

A survival after coronary artery bypass grafting surgery with ejection fraction below 30 percent

A survival after coronary artery bypass grafting surgery with ejection fraction below 30 percent

A Risk Score for Predicting Long-Term Mortality Following Off-Pump Coronary Artery Bypass Grafting

Levosimendan usage in patients with left ventricle dysfunction in coronary artery bypass graft surgery

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