On-pump beating heart coronary artery bypass surgery in patients with severe left ventricular dysfunction: Early and midterm results

Introduction and objectives: The current study analyzed and compared early and midterm outcomes of on-pump beating heart versus conventional coronary artery bypass grafting technique that requires aortic cross-clamping among patients with low ejection fraction. Methods: From January 2012 to January 2019, a total of 64 patients with low ejection fraction (<30%) underwent isolated first-time elective coronary artery bypass surgery: 32 patients underwent myocardial revascularization using on-pump beating heart, while 32 patients had on-pump with cardioplegic arrest procedures. Results: Groups were statistically similar with regard to baseline clinical characteristics. The predicted risk for surgery, according to EuroSCORE was slightly higher in the on-pump beating heart group without reaching statistical significance. No statistically significant differences were detected between the groups with respect to number of distal bypass, atrial fibrillation or cerebrovascular accidents. There was a significant reduction in intensive care unit stay (3.28 +/- 0.99 vs. 4.13 +/- 1.54, p = 0.04) and lower length of hospital stay (7.25 +/- 1.22 vs. 8.84 +/- 3.53, p = 0.042) in the on-pump beating heart group. The incidence of hospital and 5-year mortality was fewer in the on-pump beating heart, but the difference was not significant. Conclusions: Our study suggested that on-pump beating heart is associated with fewer intensive care unit and hospital stay and there was a trend towards less mortality at early and midterm follow. This technique may be an acceptable alternative in patients with severe ventricular dysfunction. (C) 2020 Sociedad Espanola de Cirugia Cardiovascular y Endovascular. Published by Elsevier Espana, S.L.U.