• Pey-Jen Yu, Dishen Lin, Michael Catalano, Hugh Cassiere, Nina Kohn, and Alan Hartman.
• Division of Cardiovascular and Thoracic Surgery, Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY. Electronic address: pyu2@northwell.edu.
• J. Cardiothorac. Vasc. Anesth. 2019 Oct 1; 33 (10): 2703-2708.

ObjectivePredictors of operative outcome in patients with severely depressed left ventricular ejection fraction (LVEF) undergoing coronary artery bypass grafting (CABG) remain poorly defined. This study aims to identify preoperative variables that are associated with increased postoperative length of hospital stay or operative mortality in this patient population.DesignRetrospective study.SettingSingle tertiary care university hospital.ParticipantsPatients undergoing isolated CABG between January 2012 and March 2017 with an LVEF ≤ 25%.InterventionsIsolated CABG.Measurements And Main ResultsPrimary endpoint was a composite of prolonged length of stay, defined as postoperative length of stay >7 days or operative mortality. Of the 201 patients, 99 (49.3%) met the primary endpoint. Patient comorbidities, clinical presentation, presence of Q-waves on electrocardiogram, and echocardiographic parameters including ventricular dimensions and right heart dysfunction were not associated with the primary endpoint. On multivariable analysis, patients who were not on preoperative beta-blockers, patients with preoperative albumin of <3.5 g/dL, and higher Society of Thoracic Surgeons Predicted Risk of Mortality score were associated with increased prolonged length of stay or death.ConclusionsMore than half of patients with severely depressed LVEF undergoing isolated CABG are able to be discharged within 7 days postoperatively. The absence of preoperative beta-blockers, low preoperative albumin levels, and higher Society of Thoracic Surgeons Predicted Risk of Mortality score are associated with more complicated or slower postoperative recovery after CABG in this patient population.Copyright © 2019 Elsevier Inc. All rights reserved.

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