[Coronary artery bypass grafting in patients with severe left ventricular systolic dysfunction: Short- and long-term outcomes]

Ann Cardiol Angeiol (Paris). 2022 Feb;71(1):11-16. doi: 10.1016/j.ancard.2021.05.006. Epub 2021 Jun 16.
[Article in French]

Abstract

Background: Ischemic heart disease with severe left ventricular systolic dysfunction is a poor prognosis. Coronary artery bypass grafting is the gold treatment in this population, despite high surgical risk.

Aim: The aim of our study is to evaluate the short- and long-term outcomes of coronary artery bypass grafting in patients with ischemic heart disease and severe left ventricular systolic dysfunction (LVEF≤35%).

Methods: Between May 1995 and December 2010, 171 patients with ischemic heart disease and severe left ventricular systolic dysfunction (LVEF≤35%) underwent isolated coronary artery bypass grafting. Hospital mortality, postoperative morbidity, all-cause death, cardiovascular death, and major adverse cardiovascular events (heart failure, recurrent angina, myocardial infarction, stroke) were evaluated. The mean follow-up was 9.3±5 years.

Results: Hospital mortality was 9.9%. Postoperative morbidity was 36.9%. Overall survival at 1-, 5- and 10-years was 97.4%, 90.5% and 43.4%, respectively. Freedom from cardiovascular death at 1-, 5- and 10-years was 98.1%, 91.8% and 55.4%, respectively. Freedom from recurrent angina at 1-, 5- and 10-years was 95.5%, 84.8% and 44.9%, respectively. Freedom from heart failure at 1-, 5- and 10-years was 89.9%, 86,8% and 53.3%, respectively. Freedom from major adverse cardiovascular events at 1-, 5- and 10-years was 88%, 82.1% and 38.2%, respectively.

Conclusion: Based on our findings, coronary artery bypass grafting can be performed in patients with ischemic heart disease and severe left ventricular systolic dysfunction with acceptable hospital morbidity and mortality and long-term survival.

Keywords: Cardiopathie ischémique; Coronary artery bypass grafting; Dysfonction systolique sévère; Ischemic heart disease; Major adverse cardiovascular events; Pontage aorto-coronaire; Severe systolic dysfunction; Survie; Survival; Événements cardiovasculaires majeurs.

MeSH terms

  • Angina Pectoris
  • Coronary Artery Bypass
  • Heart Failure*
  • Humans
  • Risk Factors
  • Treatment Outcome
  • Ventricular Dysfunction, Left*