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Original article

Vol. 142 No. 4546 (2012)

Impaired left ventricular function as a predictive factor for mid-term survival in octogenarians after primary coronary artery bypass surgery

  • Denis Berdajs
  • Sotirios Marinakis
  • Ulf Kessler
  • Mirza Muradbegovic
  • Enrico Ferrari
  • Ludwig K von Segesser
Cite this as:
Swiss Med Wkly. 2012;142:w13704


BACKGROUND: The impact of preoperative impaired left ventricular ejection fraction (EF) in octogenarians following coronary bypass surgery on short-term survival was evaluated in this study.

METHODS: A total of 147 octogenarians (mean age 82.1 ± 1.9 years) with coronary artery diseases underwent elective coronary artery bypass graft between January 2000 and December 2009. Patients were stratified into: Group I (n = 59) with EF >50%, Group II (n = 59) with 50% > EF >30% and in Group III (n = 29) with 30% > EF.

RESULTS: There was no difference among the three groups regarding incidence of COPD, renal failure, congestive heart failure, diabetes, and preoperative cerebrovascular events. Postoperative atrial fibrillation was the sole independent predictive factor for in-hospital mortality (odds ratio (OR), 18.1); this was 8.5% in Group I, 15.3% in Group II and 10.3% in Group III. Independent predictive factors for mortality during follow up were: decrease of EF during follow-up for more that 5% (OR, 5.2), usage of left internal mammary artery as free graft (OR, 18.1), and EF in follow-up lower than 40% (OR, 4.8).

CONCLUSIONS: The results herein suggest acceptable in-hospital as well short-term mortality in octogenarians with impaired EF following coronary artery bypass grafting (CABG) and are comparable to recent literature where the mortality of younger patients was up to 15% and short-term mortality up to 40%, respectively. Accordingly, we can also state that in an octogenarian cohort with impaired EF, CABG is a viable treatment with acceptable mortality.


  1. Passamani E, Davis KB, Gillespie MJ, Killip T and the CASS principal investigators and their associates. A randomized trial of coronary artery bypass surgery. Survival of patients with low ejection fraction. N Engl J Med. 1985;312:1665–71.
  2. The Veterans Administration coronary Artery Bypass Surgery Cooperative Study Group. Eleven year survival iin the veteransadministartion randomised trial of coronary bypass surgery for stable angina. N Engl J Med. 1984;311:1333–9.
  3. John R, Rajasinghe HA, Chen JM, Weinberg AD, Sinha P, Mancini DM, et al. Long-term outcomes after cardiac transplantation: and experiance based on diferent erase of immunosupressive therapy. Ann Thorac Surg. 2001;72:440–9.
  4. Alderman EL, Fisher LD, Litwin P, Kaiser GC, Myers WO, Maynard C, et al. Results of coronary artery surgery in patients with poor left ventricular function (CASS). Circulation. 1983;68:785–95.
  5. Eur Heart J. 2012;33:1787–847.
  6. Kunadian V, Zaman A, Qiu W. Revascularization among patients with severe left ventricular dysfunction: a meta-analysis of observatinal studies. Eur J Heart Fail. 2011;13:773–84.
  7. Islamoglu F, Apaydin AZ, Posacioglu H, Ozbaran M, Hamulu A, Buket S, et al. Coronary artery bypass grafting in patients with poor left ventricular function. Jpn Heart J. 2002;43:343–56.
  8. Carr JA, Haithcock BE, Paone G, Bernabei A, Silverman NA. Long term outcome after coronary bypass grafting in patients with severe left ventricular dysfunction. Ann Thorac Surg. 2002;74:1531–6.
  9. Topkara VK, Cheema FH, Kesavaramanujam S, Mercando ML, Cheema AF, Namerow PB, et al. Coronary artery bypass grafting in patients with low ejection fraction. Circulation. 2005;30:112(9 Suppl):I344–50.
  10. Jones RH, Hannan EL, Hammermeister KE, Delong ER, O’Connor GT, Luepker RV, et al. Identification of preoperative variables needed for risk adjustment of short-term mortality after coronary artery bypass graft surgery. The Working Group Panel on the Cooperative CABG Database Project. J Am Coll Cardiol. 1996;28:1478.
  11. Lee S, Chang BC, Yoo KJ, Hong YS, Kang MS. Clinical results of coronary revascularization in left ventricular dysfunction. Circ J. 2007;71:1862–6.
  12. Velazquez EJ, Lee KL, Deja MA, Jain A, Sopko G, Marchenko A, et al; STICH Investigators. Coronary-artery bypass surgery in patients with left ventricular dysfunction. N Engl J Med. 2011;28;364(17):1607–16.
  13. Siregar S, Groenwold RH, de Heer F, Bots ML, van der Graaf Y, van Herwerden LA. Performance of the original EuroSCORE Eur J Cardiothorac Surg. 2012;26(ahead of publication).
  14. Schoenenberger AW, Kobza R, Jamshidi P, Zuber M, Abbate A, Stuck AE, et al. Am J Cardiol. 2009;104(2):158–63.

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