Long-Term Outcomes after Off-Pump Coronary Artery Bypass Grafting in Left Ventricular Dysfunction

Purpose: We assessed the long-term clinical, angiographic, and echocardiographic outcomes of patients with left ventricular dysfunction (ejection fraction <= 40%) who underwent isolated off-pump coronary artery bypass grafting. Methods: One hundred sixty one patients were included. Mean age was 67.2 +/- 11.4 years, and 20 patients (12.4%) were female. Eighty-eight patients (54.7%) were New York Heart Association functional class 3 or 4. Early postoperative and follow-up angiography and echocardiography findings were analyzed, and mid-term survival rates (mean follow-up 40.7 +/- 25.6 months) were calculated. Results: Mean number of distal anastomoses was 4.4 +/- 1.3. Bilateral internal thoracic artery grafts were used in 84.5% of patients. Operative mortality was 2.5%. Early patency rate of anastomoses was 98.3%. Early postoperative ejection fraction improved from 33.1 5.6% preoperatively to 36.9 9.5% (p <0.001). Seven-year survival rate was 73.9 +/- 5.3%, and freedom from cardiac events rate was 68.5 +/- 5.2%. One-year patency rate of anastomoses was 85.8%. Follow-up ejection fraction was 39.1 +/- 10.7% (p <0.001). Conclusions: Early and long-term outcomes of off-pump coronary artery bypass grafting in patients with left ventricular dysfunction were favorable, including early postoperative and follow-up patency rates of anastomoses and echocardiographic recovery of ejection fraction.