ABSTRACT 61

SHOULD SEVERE LEFT VENTRICLE DYSFUNCTION BE AN INDICATION FOR OPCAB?

S. Woœ, M. Jasiñski, R. Bachowski, M. Gemel, P. Olszówka, D. Szurlej.  2nd Dept. Cardiac Surgery, Katowice Poland

Objective: The purpose of the study was to compare early results after OPCAB with regard to preoperative impairment of LV function.

Methods: 240 patients underwent OPCAB  between 1997 and 1999. They were retrospectively divided into two groups with regard to LV function. Group one consisted of 90 patients with EF<40% including 31 patients with EF <30% and group two of 150 patients with EF>35%. Patients were compared for preoperative risk factors, perioperative mortality and postoperative complications.

Results: Preoperative expected mortality according to EUROSCORE was higher in gr. One- 5,95 cp. gr. two-2,66 (p=0,0005). Among preoperative risk factors a few were more common in gr. one: urgent operation (p=0,00001), unstable angina (p=0,0018), CCS state (p=0,001), MI (p=0,0001), peripheral arteriopathy (p=0,0006). Mean number of grafts was 1,51 in gr. one and 1,55 in gr. two with the same ITA utilization. Perioperative drainage, anesthesia and intubation time, transfusion rate and inotropes use were comparable. Actual, nonadjusted mortality was 3% in gr. one and 0,7% in gr. two (p=ns). Overall postoperative complications were comparable, only IABP was more frequent in group one (p=0,006). Postoperative stay was shorter in group one (p=0,007).

Conclusion: OPCAB for patients with LV impairment is associated with similar surgical outcome as those with normal LV function, in spite of unfavorable preop. risk factors. Possibly, presences of poor LV function should be considered as indication for off pump CABG.