Objective To investigate surgical outcomes and prognostic factors for patients with coronary heart disease and low left ventricular ejection fraction （LVEF≤40%） undergoing off-pump coronary artery bypass grafting （OPCAB）. Methods We retrospectively analyzed clinical records of 63 discharged patients with coronary heart disease and low LVEF who underwent OPCAB in Peking University People’s Hospital from 2001 to 2004 year. There were 48 males and 15 females with mean age of 65.1±9.2 years and mean LVEF of 33.8%±5.0%. Regular follow-up evaluation was completed. We investigated risk factors for long-term survival of the patients by Kapalan-Meier survival curve, log-rank test and Cox regression model.?Results?Follow-up time was 3-107 （71.3±24.4） months, and six patients were lost during the follow-up. Nineteen patients （30.2%） died during follow-up including 10 patients （15.9%） who had cardiac-related death. The survival rate at 1, 3, 5 and 8 year was 96.7% （61）, 94.9% （60）, 85.9% （55）, 77.2% （53） respectively. Univariate analysis shows LVEF≤30% and acute myocardial infarction within 30 days are risk factors for long-term survival（P＜0.05）. Cox regression analysis showed that LVEF≤30%（RR=4.662, P＜0.05）and acute myocardial infarction within 30 days（RR=5.544, P＜0.05）were two independent risk factors for cardiac-related death after discharge. Conclusion Patients with coronary heart disease and low LVEF can have satisfactory surgical outcomes after OPCAB. LVEF≤30% and acute myocardial infarction within 30 days are the two independent risk factors for cardiac-related death after discharge.
Citation：
LING Yunpeng,LIU Xi,WU Xianqiu,CHEN Yu,CHEN Shenglong,JIN Xinxin,DONG Suixin,HU Dayi.. Long-term Outcomes of Off-pump Coronary Artery Bypass Grafting in Patients with Low Left Ventricular Ejection Fraction. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2012, 19(5): 507-510. doi:
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Copyright © the editorial department of Chinese Journal of Clinical Thoracic and Cardiovascular Surgery of West China Medical Publisher. All rights reserved
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patients with severely depressed left ventricular function. Ann Thorac Surg， 2007， 84 （3）：808-816.
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Cooper EA， Edelman JJ， Wilson MK， et al. Off-pump coronary artery bypass grafting in elderly and high-risk patients--a review. Heart Lung Circ， 2011， 20 （11）：694-703.
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王睿， 陈鑫， 石开虎， 等. 体外与非体外循环冠状动脉旁路移植术治疗高危冠心病患者的对比分析. 中国胸心血管外科临床杂志， 2008， 15 （2）：143-144.
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O’connor CM， Velazquez EJ， Gardner LH， et al. Comparison of coronary artery bypass grafting versus medical therapy on long-term outcome in patients with ischemic cardiomyopathy （a 25-year experience from the Duke Cardiovascular Disease Databank）. Am J Cardiol， 2002， 90 （2）：101-107.
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李京倖， 顾承雄， 韦华， 等. 心功能不全冠心病患者非体外循环冠状动脉旁路移植术的疗效分析. 中国胸心血管外科临床杂志， 2011， 18 （2）：157-159.
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Attaran S， Shaw M， Bond L， et al. Does off-pump coronary artery revascularization improve the long-term survival in patients with ventricular dysfunction?? Interact Cardiovasc Thorac Surg， 2010， 11 （4）：442-446.
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Filsoufi F， Rahmanian PB， Castillo JG， et al. Results and predictors of early and late outcome of coronary artery bypass grafting in.
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Caputti GM， Palma JH， Gaia DF， et al. Off-pump coronary artery bypass surgery in selected patients is superior to the conventional.
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Goldstein DJ， Beauford RB， Luk B， et al. Multivessel off-pump revascularization in patients with severe left ventricular dysfunction. Eur J Cardiothorac Surg， 2003， 24 （1）：72-80.
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| 13. |
Joseph CJ， Shroyer AW， Anita YC， et al. Off-pump coronary artery bypass grafting decreases risk-adjusted mortality and morbidity. Ann Thorac Surg， 2001， 72 （4）：1282-1289.
|
| 14. |
Inaba H， Tambara K， Yamamoto T， et al. Off-pump coronary artery bypass grafting for patients with left ventricular dysfunction. Asian Cardiovasc Thorac Ann， 2010， 158 （2）：227.
|
| 15. |
Elefteriades JA， Morales DL， Gradel C， et al. Results of coronary artery bypass grafting by a single surgeon in patients with left ventricular ejection fractions ＜or=30%. Am J Cardiol， 1997， 79 （12）：1573-1578.
|
| 16. |
Filsoufi F， Rahmanian PB， Castillo JG， et al. Results and predictors of early and late outcome of coronary artery bypass grafting in patients with severely depressed left ventricular function. Ann Thorac Surg， 2007， 84 （3）：808-816.
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| 17. |
Nashef S， Roques F， Michel P， et al. European system for cardiac operative risk evaluation （EuroSCORE）. Eur J Cardiothorac Surg， 1999， 16 （1）：9-13.
|
- 1. patients with severely depressed left ventricular function. Ann Thorac Surg， 2007， 84 （3）：808-816.
- 2. approach for patients with severely depressed left ventricular function. Clinics （Sao Paulo）， 2011， 66 （12）：2049-2053.
- 3. Puskas JD， Edwards FH， Pappas PA， et al. Off-pump techniques benefit men and women and narrow the disparity in mortality after coronary bypass grafting. Ann Thorac Surg， 2007， 84 （5）：1447-1454.
- 4. 万峰， 陈彧， 王京生， 等. 非体外循环冠状动脉旁路移植术在低射血分数患者中的应用. 中国循环杂志， 2002， 17 （5）：383-385.
- 5. Cooper EA， Edelman JJ， Wilson MK， et al. Off-pump coronary artery bypass grafting in elderly and high-risk patients--a review. Heart Lung Circ， 2011， 20 （11）：694-703.
- 6. 王睿， 陈鑫， 石开虎， 等. 体外与非体外循环冠状动脉旁路移植术治疗高危冠心病患者的对比分析. 中国胸心血管外科临床杂志， 2008， 15 （2）：143-144.
- 7. O’connor CM， Velazquez EJ， Gardner LH， et al. Comparison of coronary artery bypass grafting versus medical therapy on long-term outcome in patients with ischemic cardiomyopathy （a 25-year experience from the Duke Cardiovascular Disease Databank）. Am J Cardiol， 2002， 90 （2）：101-107.
- 8. 李京倖， 顾承雄， 韦华， 等. 心功能不全冠心病患者非体外循环冠状动脉旁路移植术的疗效分析. 中国胸心血管外科临床杂志， 2011， 18 （2）：157-159.
- 9. Attaran S， Shaw M， Bond L， et al. Does off-pump coronary artery revascularization improve the long-term survival in patients with ventricular dysfunction?? Interact Cardiovasc Thorac Surg， 2010， 11 （4）：442-446.
- 10. Filsoufi F， Rahmanian PB， Castillo JG， et al. Results and predictors of early and late outcome of coronary artery bypass grafting in.
- 11. Caputti GM， Palma JH， Gaia DF， et al. Off-pump coronary artery bypass surgery in selected patients is superior to the conventional.
- 12. Goldstein DJ， Beauford RB， Luk B， et al. Multivessel off-pump revascularization in patients with severe left ventricular dysfunction. Eur J Cardiothorac Surg， 2003， 24 （1）：72-80.
- 13. Joseph CJ， Shroyer AW， Anita YC， et al. Off-pump coronary artery bypass grafting decreases risk-adjusted mortality and morbidity. Ann Thorac Surg， 2001， 72 （4）：1282-1289.
- 14. Inaba H， Tambara K， Yamamoto T， et al. Off-pump coronary artery bypass grafting for patients with left ventricular dysfunction. Asian Cardiovasc Thorac Ann， 2010， 158 （2）：227.
- 15. Elefteriades JA， Morales DL， Gradel C， et al. Results of coronary artery bypass grafting by a single surgeon in patients with left ventricular ejection fractions ＜or=30%. Am J Cardiol， 1997， 79 （12）：1573-1578.
- 16. Filsoufi F， Rahmanian PB， Castillo JG， et al. Results and predictors of early and late outcome of coronary artery bypass grafting in patients with severely depressed left ventricular function. Ann Thorac Surg， 2007， 84 （3）：808-816.
- 17. Nashef S， Roques F， Michel P， et al. European system for cardiac operative risk evaluation （EuroSCORE）. Eur J Cardiothorac Surg， 1999， 16 （1）：9-13.
