• Nabil Iftikhar Awan, Azam Jan, Mujeeb Ur Rehman, and Narmeen Ayaz.
• Dr. Nabil Iftikhar Awan MBBS. Post-Graduate Resident, Department of Cardiovascular & Thoracic surgery, Rehman Medical Institute, Peshawar, Pakistan.
• Pak J Med Sci. 2020 Nov 1; 36 (7): 1454-1459.

Background And ObjectivesPatients with low ejection fraction undergoing isolated CABG surgery are at a higher risk for postoperative complications and mortality. This study was conducted to evaluate the impact of ejection fraction on the outcome of isolated Coronary Artery Bypass Grafting (CABG).MethodsBetween July, 2017 to May, 2019 total 1214 patients underwent isolated CABG. Patients were divided into three groups based on their pre-operative Ejection Fraction (EF). Group-I included 625 patients with EF >50% [Normal EF], Group-II included 484 patients with EF 35-50% [Mild to Moderately Reduced EF], and Group 3 included 105 patients with EF<35% [Severely Reduced EF].ResultsThe mean age of Group-I was 57.58 ± 9.206, Group-II was 58.38±9.124 and Group-III was 58.81± 8.663. The male gender was the predominant gender in all three groups: 194(41.1%) in Group-I, 201(52.6%) in Gp2, 52 (61.9%) in Group-III. 231(36.9) patients in Group-I, 234(48.3)in Group-II and 59(56.2) in Group-III had raised creatinine pre operatively. 5(0.8%) patients in Group-I, 2(0.4%) in Group-II and 3(2.9%) in Group-III had history of CVA. Hypertension was present in approximately 60% of all our patients. In the per-operative period 20(3.2%) patients in Group-I required an IABP as compared to 73(15.1%) in Group-II and 41(39.0%) in Group-III. The mean post-operative mortality in Group-I was 19 (3%), Group-II was 24(5.0%) and low EF group was 9(8.6%).ConclusionsThe results clearly indicate that worsening pre-operative ejection fraction is associated with a higher mortality post-operatively in patients undergoing isolated CABG. In addition, use of IABP increases as pre-operative LVEF decreases.Copyright: © Pakistan Journal of Medical Sciences.

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