The effect of low ejection fraction on mortality in coronary artery bypass grafting (CABG) patients | [Gomal Journal of Medical Sciences • 2023]

Author(s):

1. Haseeb Ahmed: Departments of Cardiothoracic and vascular surgery, Peshawar. Pakistan

2. Meenal Sikander Khan: Departments of Cardiothoracic and vascular surgery, Peshawar. Pakistan

3. Rafat Shakil: Departments of Cardiothoracic and vascular surgery, Peshawar. Pakistan

4. Azam Jan: Departments of Cardiothoracic and vascular surgery, Peshawar. Pakistan

5. Bahauddin Khan: Departments of Cardiothoracic and vascular surgery, Peshawar. Pakistan

6. Mujahid Ul Islam: Department of Anesthesia, RMI, Peshawar. Pakistan

7. Ahmad Deedar Khan: Department of Medicine, Kabir Medical College, Peshawar. Pakistan

8. Zarkesha Aman: Department of Ophthalmology, Hayatabad Medical Complex Peshawar, Pakistan

9. Waasay Hassan Khan: Department of Radiology, Khyber Teaching Hospital Peshawar, Pakistan

10. Noor Ali Shah: ICU, Rehman Medical Institute Peshawar. Pakistan

Abstract:

Background: Despite advancements in medication therapy and surgical procedures, it is still challenging to treat individuals with coronary artery disease having a poor ejection fraction (EF). The aim of this study was to compare patients having less than 40% ejection fraction with those patients having more than 40% ejection fraction undergoing coronary artery bypass graft surgery in terms of in hospital morbidity and mortality. Material and Methods: This was a descriptive study done from 1st January to 30th March 2022. This study included all the patients' record from year 2017 till 2021, which got coronary artery bypass graft (CABG) surgery. All those having concomitant valve or congenital anomalies along with CABG were excluded from study. Qualitative variables were analyzed as frequency and percentages, while quantitative variables as mean and standard deviations. We utilized the SPSS software version 23 for data entry and analysis. For statistical analysis, the Chi-squared test was employed. P-values lower than 0.05 were deemed significant. Results: Total 1902 patients were equally divided into 2 groups depending on their EF. Group A had low EF (<40%) patients while Group B had >40% EF. The age, gender, weight, height, renal and lipid profile, number of diseased coronary vessels and co existing vascular conditions were matching in both groups. The in hospital mortality for group A was 6.2% as compared to group B i.e. 3.3% with 0.005 p value. The use of Intra-Aortic Balloon Pump (IABP) was strongly associated with patients of group A in our study with 22.2% vs 2.6% in group B and a p value of 0.00001. Conclusion: Patients with <40% ejection fraction is strongly associated with increased in hospital mortality and morbidity undergoing isolated CABG. The perioperative use of IABP is more in low ejection fraction patients undergoing CABG surgery.

Page(s): 37-41

DOI: 10.46903/gjms/21.01.1253

Published: Journal: Gomal Journal of Medical Sciences, Volume: 21, Issue: 1, Year: 2023

Keywords:

Cardiac surgery , Mortality , Ejection fraction , Coronary artery bypass graft , Intraaortic balloon pump

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