Study to determine improvements in LVEF & NYHA class in patients with
severe left ventricular dysfunction undergoing CABG at a tertiary care
hospital
Abstract
Background: Careful preoperative selection and operative management in
coronary artery disease patients with low EF undergoing CABG improve
early outcome(LVEF,NYHA class). Material and Methods:This is descriptive
observational retrospective study of 113 patients of coronary artery
disease with moderate to severe left ventricular dysfunction who
underwent CABG during study period. Results: Male patients (76%)
outnumbered female patients (24%). Male to female ratio was 3.19:1.
Most common age group was 60-69 yrs (34 %), followed by 70-79 yrs (29
%) & 50-59 yrs (21 %) . Mean age was 66.28 yrs. Majority patients had
LM (43 %) & TVD (Triple vessel disease)(42%) as coronary artery
disease in present study.LIMA+Vein (91 %) were most commonly used
grafts . 61 (54 %) patients needed 3 grafts, while 24 (21%) & 19
(17%) respectively required 4 & 2 grafts respectively. 32(29 %)
patients had mitral regurgitation. In 6(5 %) patients emergency CABG
was done. Total mortality rate was 7.9%. We compared LVEF values in
preop, immediate postop & 3 months follow up period. Statistically
significant (p – 0.004) difference was noted in pre-op & 3 months
follow up values of LVEF. Similarly we compared NYHA class in preop & 3
months follow up period. A statistically significant (p – 0.003)
difference was noted in pre-op & 3 months follow up values of NYHA
class in our patients. Conclusion: Postoperative improvement of EF and
NYHA functional class reflects the high benefit of CABG in patients with
coronary artery disease with moderate to severe LV dysfunction.