Objective: To investigate the outcomes and prognostic factors for patients with coronary artery disease and low left ventricular ejection fraction (LVEF≤40%) undergoing off-pump coronary artery bypass grafting OPCAB).
Methods: From 2001 to 2004, 71 patients with low EF undergoing OPCABG in our hospital, the mean age is 65.0±9.0 years (from 37 to 81), 49 males and 16 females, the mean EF was 33.8±5.0%. Regular follow-up evaluation was completed. Draw the Kaplan-Meier survival curves, Use the log-rank test and Cox regression model to find out the factors that affect the long-term result.
Results: 71 low LVEF patients, 6 patients died perioperative, 63 patients discharged successfully, the follow-up time was 64.9±30.4 months. 6 patients lost of follow up, 19 patients died during follow-up including 10 patients (15.9%) who had cardiac-related death. The survival rate at 1, 3, 5 and 8 years was 95.1%, 93.3%, 86.3%, 77.7%, respectively. Univariate analysis shows EF≤30% and acute myocardial infarction within 30 days are risk factors for the long-term survival (P<0.05). Cox regression analysis showed that EF≤30% (RR=6.446, P<0.05) and acute myocardial infarction within 30 days (RR=5.993, P<0.05) are two independent risk factors for the cardiac-related death after discharge.
Conclusions: The patients with low eject fraction ventricular have satisfactory outcomes after OPCAB. LVEF≤30% and acute myocardial infarction within 30 days are two independent risk factors that affect the long-term outcome.
Keywords: Low eject fraction; artery bypass grafting; off-pump; survival analysis.