Long-Term Result of CABG in Patients with Low Left Ventricular Function. On Pump Arrest vs On Pump Beating vs Off Pump

Onichi Furuya, Shinnichi Higashiue, Satoshi Kuroyanagi, Masatoshi Komooka, Norihiko Hiramatsu, Saburo Kojima, Naohiro Wakabayashi

Kishiwada Tokushukai Hospital, kishiwada Oosaka, Japan

Date, time and location: 2018.05.25 15:30, Congress Hall, 2F–A

Abstract

【INTRODUCTION】Which strategy, on pump arrest, on pump beating or off pump, is the best for coronary artery bypass grafting (CABG) in patients with low left ventricular function is still controversial. This study aimed to research the long term results of the three groups to explore which technique would be more suitable for CABG in patients with low left ventricular function 

【METHODS】Between January 2003 and December 2017, 361 patients with a left ventricular ejection fraction (LVEF) of 40% or less underwent isolated CABG in our hospital. Sixty-five patients underwent on pump arrest CABG (group A), 152 patients underwent on pump beating CABG (group B) and 144 patients underwent off pump CABG (group C). The long term survivals and major adverse cardiac and cerebrovascular events (MACCE)-free ratio were investigated and compared.

【RESULTS】Group C was older than group A (group A 66.4±11.2, group B 67.3±10.2, group C 70.1±10.3, p=0.018) and group C had a higher postoperative LVEF than group B (group A 30.4±7.2, group B 29.7±7.1, group C 31.9±6.3, p=0.015) . There was no significant difference among the three groups for operative mortality (group A 4.6% vs group B 4.6% vs group C 3.5%, p=0.869). One-, and 5-year survival rates were 84.1% and 73.2% in group A vs 90.5% and 69.0% in group B vs 85.3% and 55.7% in group C (p=0.098). The MACCE-free ratio at 1-, and 5-year were 92.3% and 67.6% in group A vs 90.8% and .63.9% in group B vs 93.5% and 74.1% in group C (p=0.080).

【CONCLUSION】CABG for low left ventricular function patients in our hospital, there were no significant difference among on pump arrest CABG, on pump beating CABG and off pump CABG for long-term survival and MACCE-free ratio.