Outcomes of isolated CABG from "OPCAB favor institution" for patients with left ventricular dysfunction.

OBJECTIVES

Although off-pump coronary artery bypass (OPCAB) has been reported to have better short-term results than on-pump coronary artery bypass (ONCAB) in terms of bleeding and stroke even in patients with cardiac dysfunction, details are unknown. The purpose of this study was to evaluate the outcomes of CABG (coronary artery bypass graft) in patients with low cardiac function based on our treatment policy.

METHODS

Retrospectively, we reviewed patients with low ejection fraction (< 35%), who underwent isolated OPCAB or ONCAB between 2013 and 2020 in our institute.

RESULTS

Isolated CABG was performed for 67 patients: 54 OPCABs and 13 ONCABs. In the ONCAB group, six were converted from OPCAB. Patients with AMI, heart failure, liver dysfunction, cardiogenic shock, and ventricular arrhythmia were more common in the ONCAB group. More patients required postoperative mechanical circulatory support in the ONCAB group. Intra-operative blood transfusion, ICU stay, intubation time, and hospital stay were significantly worse in the ONCAB group. Postoperative graft patency was 91.5%. Hospital mortality was 7.5%. Mid-term survival at 30-day, 1-year, and 5-year were 98.5%, 84.6%, and 75.8%, respectively.

CONCLUSION

In our institute, ONCAB was selected for the patients who could not complete treatment with OPCAB due to poor preoperative circulatory status. Our treatment policy for the patients with impaired cardiac function was acceptable.