Coronary Artery Bypass Surgery Improves Left Ventricular Ejection Fraction in Patients with Ischemic Cardiomyopathy

Objectives: Controversy exists about the recovery of left ventricular systolic function after coronary artery bypass surgery in patients with ischemic cardiomyopathy. Aim of this study is the evaluation of left ventricular systolic function postoperatively, in patients with ischemic cardiomyopathy undergoing coronary artery bypass surgery.

Methods: We performed a retrospective analysis of the data of 38 patients with ischemic cardiomyopathy and left ventricular ejection fraction ≤35%, undergoing isolated coronary artery bypass surgery in a single center in the period 2009 to 2019. Left ventricular ejection fraction was assessed preoperatively, at 3 months and 1 year postoperatively. Wilcoxon's signed-rank test, Student's t-test, Mann–Whitney U-test, Pearson's correlation, and Spearman's correlation were performed to assess for and identify factors leading to left ventricular ejection fraction improvement postoperatively.

Result: Median left ventricular ejection fraction preoperatively was 25%, mean patient age was 63 years, 32 (84.2%) patients were male, 24 (63.2%) had a previous myocardial infarction, 12 (31.6%) had a previous percutaneous coronary intervention, 29 (76.3%) were operated off-pump, and 2 (5.3%) were emergency procedures. There was no in-hospital death, postoperative myocardial infarction, cerebrovascular insult, and reexploration for bleeding or tamponade. At 1 year postoperatively, there was no death, no repeat revascularization, no myocardial infarction, 1 (2.6%) patient had a cerebrovascular insult, and 10 (26.3%) required a cardioverter-defibrillator implantation. There was a statistically significant median ejection fraction increase at 3 months (10%, p < 0.0005) and 1 year (14%, p < 0.0005) postoperatively. Preoperative left ventricular ejection fraction was negatively associated with the magnitude of ejection fraction improvement at 1 year postoperatively (p = 0.017).

Conclusion: Patients with ischemic cardiomyopathy and left ventricular ejection fraction ≤35% undergoing coronary artery bypass surgery show excellent 1-year postoperative outcomes with significant improvement in left ventricular systolic function, low mortality, and low rates of major adverse cardiovascular events. Coronary artery bypass surgery leads to recovery of left ventricular systolic function in patients with ischemic cardiomyopathy.

No conflict of interest has been declared by the author(s).

Publication History

Article published online:
19 February 2021