Journal Article

Off-pump versus on-pump coronary artery bypass graft surgery outcomes in patients with severe left ventricle dysfunction: inverse probability weighted study

Sadeghian, Saeed, Mansourian, Soheil, Pashang, Mina, Tajdini, Masih, Shirzad, Mahmoud, Fallahzadeh, Aida, Hosseini, Kaveh, Forouzannia, Khalil, Sheikhy, Ali, Momtahen, Shahram

2022

Overview

Objective In this study we aimed to compare on-pump and off-pump coronary artery bypass grafting (CABG) outcomes in patients presented with low left ventricular ejection fraction (EF) as a high-risk group of patients. Methods In this registry-based study from 2014 and 2016, all patients with severe left ventricular dysfunction (EF less than 35%) were included and followed until 2020. The median follow-up period was 47.83 [38.41, 55.19] months. Off pump CABG (OPCABG) was compared with on-pump CABG (ONCABG) in terms of mid-term non-fatal cardiovascular events (CVEs) and all-cause mortality. Propensity score method (with inverse probability weighting technique) was used to compare these two groups. Results From 14,237 patients who underwent isolated CABG, 2055 patients with EF ≤ 35% were included; 1705 in ONCABG and 350 patients in OPCABG groups. Although OPCABG was associated with lower risk of 30-days mortality (Odds Ratio [OR]: 0.021; Confidence Interval [CI] 95% [0.01, 0.05], P  < 0.001); there was no significant difference between OPCABG and ONCABG in term of mid-term mortality and non-fatal CVEs ((Hazard ratio [HR]: 0.822; 95%CI [0.605, 1.112], p  = 0.208) and (HR: 1.246; 95%CI [0.805, 1.929], p  = 0.324), respectively). Patients with more than three traditional coronary artery disease risk factors, had more favorable outcomes (in terms of mid-term mortality) if underwent OPCABG (HR: 0.420; 95%CI [0.178, 0.992], p  = 0.048). Conclusion OPCABG was associated with lower risk of 30-days mortality; however, mid-term outcomes were comparable in both OPCABG and ONCABG techniques.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Angiology / Blood pressure / Blood Transfusion Medicine / Cardiac output / Cardiac Surgery / Cardiology / Cardiovascular disease / Care and treatment / Coronary artery bypass / Coronary artery bypass surgery / Coronary artery disease / Coronary heart disease / Coronary vessels / Diabetes / Ejection fraction / Health aspects / Heart / Heart diseases / Hospitals / Internal Medicine / Kidney diseases / Left ventricular dysfunction / Measurement / Medical imaging / Medicine / Medicine & Public Health / Mortality / Patient outcomes / Patients / Probability / Risk factors / Risk groups / Stroke / Surgeons / Surgery / Survival analysis / Sutures / Transient ischemic attack / Variables / Ventricle