The Application Of Off-pump Coronary Artery Bypass Grafting (OPCAB) On The Coronary Heart Disease Patient With Low LVEF

Objective: The purpose of this study is to estimate the effect of OPCAB on the coronary heart disease (CHD) patient with low LVEF. Method: 145 patients who had been undergone the off-pump coronary artery bypass grafting (OPCAB) in our department from Jun 2002 to Dec 2004 were analysised retrorespectively .Among these cases, 41 patients' EF which are measured by echocardiography and LV angiography are lower than 45%(means35.7±9.2%). The preoperative EF, LVSD, LVDD and postoperative EF, LVSD, LVDD after one week and three months were registered; The patients'NYHA and CCS degree before operation and when the patients discharged from hospital were estimated; The preoperative and postoperative Cr, BUN and PLT were measured , Result: 1 patient died of low cardiac output syndrome in the 14 hours after operation. 5 patients had postoperative complications. Compared with preoperative results, there were no significant changes in EF and LVSD measured one week later(P>0.05), however LVDD shortened obviously(P< 0.01).After 3 months of operation, the EF hanced(P<0,05) and LVDD shortened greatly(P<0.01), however LVSD had no changes(P >0.05). The NYHA of 34 patients and the CCS of 37 patients were improved 1~2 degrees when they discharged from hospital and Cr, BUN, PLT measured after 8h of operation had no significant changes(P > 0.05). After operation, the all patients'angina pectoris syndrome disappeared or relieved and active ability improved greatly. Conclusion:The OPCAB is safe procedure and is widely indicated. It may minimize the surgical trauma and complication of cardicpulmonary bypass (CPB). CHD patient with low EF could avoid and reduce CPB impairment and reperfusion impaired by undergoing OPCAB .This kind of operation is feasible to perform and has satisfied early postoperative effect. However it's postoperative long-term outcome will be observed.