The impact of total arterial revascularization off pump coronary bypass grafting in impaired left ventricular function

Background

The Arterial grafts have the advantage of durability and may have a protective effect by reducing the progression of native coronary artery disease (CAD) in grafted vessels. This study aimed to evaluate the impact of total arterial revascularization off pump coronary artery bypass grafting (CABG) in impaired left ventricular (LV) function patients with Ejection Fraction (EF) ≤ 35% concerning the short-term results.

Methods

From August 2006 to August 2015, 287 patients with EF ≤ 35% out of 1950 patients underwent CABG in our Department of Cardiac-Thoracic Surgery, Zagazig University hospital, Egypt, for myocardial revascularization procedures were studied with a prospective registry of their data. Group 1 included 137 patients subjected to total arterial revascularization off Pump (TAROP) and Group 2 included 150 patients subjected to conventional technique (C-CABG).

Results

Hospital mortality was less in group 1 (4.37% versus 4.66%). The duration of intensive care unit stay and the hospital stay were shorter in the group 1, with statistical significance. The mean graft patency rate for 113 (82.5%) patients of group 1 (TAROP) and 113 (75.3%) group 2 (C-CABG, utilizing internal mammary and venous grafts) at one month were 98.2% and 80.5% respectively. The short-term outcome revealed that the mean postoperative LVEF improved significantly, from 29% ± 1.7% to 41.0% ± 2.0% (p < 0.05) for group 1 with an improvement of the NYHA classification of the patients in both groups.

Conclusions

Total arterial revascularization off-pump CABG in impaired left ventricular function can be achieved in most cases with low complication and mortality rates and accepted results.