| Objective:Compare patients with lower left ventricular ejection fraction(EF40%～49%)and patients with normal left ventricular ejection fraction(EF≥50%)after coronary artery bypass grafting(CABG)whether the data is different,to evaluate the therapeutic effect of coronary artery bypass grafting on patients with lower ejection fraction.Methods: A retrospective analysis of the clinical data of patients undergoing coronary artery bypass grafting in the Second Hospital of Hebei Medical University from January 2020 to September 2020.All patients underwent coronary artery bypass grafting under general anesthesia.According to the preoperative cardiac color Doppler ultrasound data,they were divided into lower ejection scores(EF40%～49%)and normal ejection scores(EF≥50%).There were 32 patients with lower ejection scores,23 males and 9 females.The preoperative EF values measured by echocardiography were between 40% and 49%.There were 237 patients with normal ejection fraction,including 175 males and 62 females.The preoperative EF values measured by echocardiography were all ≥50%.Record the two groups of patients’ gender,age,BMI,preoperative coronary angiography results involving left main disease,previous hypertension,diabetes,hyperlipidemia,old history of myocardial infarction,old history of cerebral infarction,history of PCI treatment and matching propensity scores Screen patients,try to eliminate the confounding bias of preoperative related factors.Record the number of graft vessels,operation time,whether to use extracorporeal circulation,whether to use IABP after operation,ventilator-assisted ventilation time,ICU monitoring time,blood transfusion,hospital stay,postoperative complications,mortality and compare them;Record the preoperative EF and LVDD of the two groups of patients were compared with the results of the one week postoperative review.Results:1.Patients with lower ejection fraction of coronary heart disease are more likely to have malignant arrhythmia and circulatory instability during the process of coronary artery bypass grafting,and the proportion of patients with coronary heart disease who converted to CPB is higher than those with normal ejection fraction,the difference is statistically significant(P<0.05).2.Compared with CHD patients with normal ejection fraction,CHD patients with lower ejection fraction were more likely to develop acute kidney injury after coronary artery bypass transplantation,with statistical significance(P<0.05).3.There was no significant difference in mortality after coronary artery bypass grafting between patients with normal ejection fraction and those with lower ejection fraction.4.Coronary artery bypass grafting can improve EF and reduce LVDD in patients with CHD.Compared with CHD patients with normal ejection fraction,this clinical effect was more significant in patients with lower ejection fraction of CHD,the difference was statistically significant(P<0.05).Conclusions:Through propensity score matching analysis,compared with patients with coronary heart disease with normal ejection fraction,the proportion of patients with lower ejection fraction coronary heart disease who are converted to CPB during surgery is higher,and the corresponding surgical risk is increased.Compared the mortality rate with normal ejection fraction.There was no significant difference between patients,but the incidence of complications was higher than that of patients with normal ejection fraction.CABG can significantly increase EF and reduce LVDD in patients with coronary heart disease with lower ejection fraction.For patients with lower ejection fraction,CABG is feasible and has significant short-term effects.The long-term effects need further observation... |
