Title : Cardiac surgery in patients with low ejection fraction
Abstract:
Objective: To see the outcome of cardiac surgery in patients with low ejection fraction.
Methods: We retrospectively reviewed 2382 cardiac surgery cases from 11.6.17 to 24.3.25. Among them CABG was performed in 2278 (95.63%) patients in this patient’s group 148 (6.50%) patients were in low ejection fraction group (20% - 30%). In this group 20% - 25% ejection fraction was in 46 patients (2.02%) and 26% - 30% ejection fraction was in 92 patients (4.04%). Age range was from 33 to 75 years.1 graft was given to 3 patients (2.03%), 2 graft was given to 37(25. %) patients, 3 graft was given to 108 (72.97%) patients and 4 graft was given to 20(13.51%) patients.
Endarterectomy was needed in 16(10.81%) patients. 3 grafts with mitral valve replacement in 2 patients ,1 graft with mitral valve replacement with atrial septal defect closure was done in a patient with 20% ejection fraction, 1 graft was given to a patient with Aortic Valve Replacement. In 3 patients calcified aorta was found where both internal mammary arteries were used.
We operated 23 noncoronary cardiac cases with low ejection fraction. Among them severe aortic stenosis were 8 cases, aortic regurgitation 3 cases, severe mitral stenosis 6 cases, mitral regurgitation 2 cases, atrial septal defect 2 cases, coarctation of aorta with severe aortic regurgitation1 case, patent ductus arteriosus in 1 case.
Results: Overall ejection fraction improved in CABG cases 10.54%. There was 4 (2.70%) postoperative mortality in 30 days due to respiratory failure, intractable arrhythmia and high fever. Overall mortality in 8 years was 11 (7.43%). In noncoronary cases overall ejection fraction improved 20.25%. Early 30 days mortality was1(4.34%) in the patient with severe mitral stenosis who died due to cardiac arrhythmia. Overall mortality in 8 years was 2 (8.6%).
Conclusion: Cardiac surgery in low ejection fraction patients group shows improvement in ejection fraction and gives long term good outcome.
