OUTCOMES OF PATIENTS WITH POOR LEFT VENTRICULAR FUNCTION IN OFF PUMP (OPCAB) AND ON PUMP(CCAB) CORONARY ARTERY BYPASS GRAFTING

Abstract

Objective: To compare the clinical characteristics and in hospital outcomes of patients with left ventricular ejection fractions of less than 40% who underwent coronary artery bypass graft with or without cardiopulmonary bypass.

Study Design: Descriptive cross sectional.

Place and Duration of Study: This study was conducted at Army Cardiac Centre Lahore from January 2013 to October 2014.

Material and Methods: The data pertaining to the pre, per and post operatives characteristics of the enrolled patients were collected at the time of operation and entered into SPSS database for descriptive and inferential analysis.

Results: Mean age in group A Off pump coronary artery bypass graft (OPCAB) was 57 yrs ± 8.61 versus group B on pump coronary artery bypass graft (CCAB) 55± 10.5 with the gender distribution of males and females in group A as [Males 132(86.3%)Females 21(13.7%)] and group B [Males= 192(91.2%) females = 19(8.8%)]. The number of patients with hypertension and diabetes was higher in group B 92 (43.6%) and 65 (30.8%) respectively. The mortality of the patients undergoing intervention with CCPB was 9(4.2%) versus 5(3.3%) in the off pump OPCAB group. There were statistically significant differences in the postoperative complications among the two groups.

Conclusion: Coronary artery bypass grafting without cardiopulmonary bypass is preferred in patients with severe left ventricular dysfunction. It is valid and safe in our local population and promotes less morbidity and mortality in comparison with conventional operative technique.