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Coronary Artery Bypass Grafting in Left Ventricular Dysfunction

Institute of Cardiovascular Diseases Madras Medical Mission Chennai, Tamil Nadu, India

For reprint information contact: Mullasari Ajit Sankaradas, DM Tel: 91 44 656 5961 Fax: 91 44 656 5859 email: mmmbits{at}giasmd01.vsnl.net.in Institute of Cardiovascular Diseases, Madras Medical Mission, 4A Dr. J Jayalalitha Nagar, Mogappair East, Chennai, Tamil Nadu 600050, India.

Postoperative mortality and morbidity were assessed in 75 patients with left ventricular dysfunction (ejection fraction < 35%) undergoing coronary artery bypass surgery between January 1995 and February 1999. The operative mortality was 10.7%. A rise in creatine kinase-MB isoenzyme, respiratory infection, ventricular arrhythmias, and hypotension were the most frequent complications. Of 25 variables evaluated by bivariate analysis, use of intraaortic balloon pump support, duration of intensive care stay, episodes of hypotension, low cardiac output, and deterioration of renal and liver function were associated with increased mortality. Morbidity, defined as postoperative hospital stay > 14 days, correlated with higher preoperative dyspnea class, longer cardiopulmonary bypass time, postoperative wound infection, pleural effusion, increased serum creatinine, perioperative intraaortic balloon pump support, and stroke. Postoperative low cardiac output with consequent renal failure, liver failure, and ultimately multiorgan failure, was the most important cause of mortality.