مقايسه بقاي كوتاه مدت و عوامل مرتبط با آن در ميان مبتلايان و غيرمبتلايان به نقص شديد كاركردي بطن چپ به دنبال جراحي پيوند باي پس شريان كرونري

Comparison of short time survival and its related factors in patient with and without severe left ventricular dysfunction underwent coronary artery bypass graft

Abstract Aims: Although the prognosis of advanced ischemic heart disease is poor, coronary artery bypass grafting in patients with severe left ventricle dysfunction remains controversial. This study was performed with the aim of evaluation and comparison of the surgery results and survival in these patients, regarding left ventricular function and the dysfunction degree. Materials & Methods: This retrograde cohort study was performed on 1024 patients who underwent coronary artery bypass graft in one of Tehranʹs hospitals from February of 2003 to February of 2007. Patients were divided into two groups with or without left ventricular ejection fraction lower than or equal to 35%. Data were analyzed using descriptive statistical indices and Kaplan-Meier and Cox regression analysis SPSS 17 software. Results: One year survival rate was 90.1% for group who suffered from severe left ventricle dysfunction and 99% for the group without left ventricle dysfunction and there was no significant difference between two groups. The hospital mortality rate was 1.4%. Age, left ventricle dysfunction, renal failure, hypertension and NYHA III & IV functional classes had great impact on patient survival but effects were not significantly different between two groups. Conclusion: Coronary artery bypass grafting can be performed safely on patients who suffer from severe left ventricular dysfunction, with a good short-term survival. Although adverse cardiac outcome and mortality rate is higher, it seems to have potential treatment benefits for patients. Keywords: Coronary Artery Bypass Graft, Left Ventricle Dysfunction, Short-term Survival, Risk Factor