OBJECTIVE

To evaluate the immediate results of surgical treatment of coronary artery disease in patients with reduced left ventricular ejection fraction, to compare the outcomes and incidence of complications after off-pump and on-pump coronary artery bypass grafting.

MATERIAL AND METHODS

A retrospective study included 333 patients with reduced left ventricular ejection fraction who underwent coronary artery bypass surgery in 2008—2018. Patients were divided into 2 groups: 1 control group — on-pump coronary artery bypass grafting with warm-blood cardioplegia (ONCABG, n=153 patients), 2 study group — off-pump coronary artery bypass grafting (OPCABG, n=180 patients).

RESULTS

Duration of postoperative mechanical ventilation was significantly less in the study group (p=0.006). Both groups had an inflammatory response, but this process was significantly higher in the control group (p=0.004). In both groups, surgery improved myocardial contractility in early postoperative period by 17% (p=0.8). End-systolic and end-diastolic volumes were significantly reduced after surgery in both groups (p=0.4). Postoperative neurological morbidity was lower after OPCABG compared to ONCABG (p=0.036). In the study group, the incidence of postoperative cardiovascular and respiratory complications was significantly lower than in the control group (p=0.045). Need for re-sternotomy and renal replacement therapy was lower in the study group compared to the control group (p=0.023 and p=0.048, respectively). In-hospital mortality was significantly lower in the control group (p=0.004).

CONCLUSION

Off-pump CABG in patients with reduced left ventricular ejection fraction is an effective alternative to conventional on-pump surgery. Moreover. This procedure ensures less incidence of postoperative complications and mortality.