Assessment of Left Ventricular Function in OPCABG Patient (DVD vs TVD)

Abstract

Background: Off-pump coronary artery bypass grafting (OPCABG) is increasingly utilized to minimize the adverse effects of cardiopulmonary bypass, particularly in patients with multivessel coronary artery disease. However, the influence of coronary disease burden on postoperative left ventricular (LV) functional recovery remains underexplored.

Methods: This prospective observational study was conducted at the Department of Cardiac Surgery, Bangladesh Medical University and Al Helal Specialized Hospital, Mirpur, Dhaka, from January 1 to December 31, 2024. A total of 100 patients undergoing elective OPCABG were enrolled and categorized into two groups based on coronary angiography: 50 with double vessel disease (DVD) and 50 with triple vessel disease (TVD). Echocardiographic and clinical outcomes were assessed preoperatively, on postoperative day 7, and at 3 months.

Results: Baseline demographic and clinical characteristics were comparable between the groups. Postoperative LVEF improved significantly in both groups, with a greater increase in the DVD group (+6.4% vs. +4.5%, p = 0.001). At 3 months, LVEF, LVEDD, and LVESD were significantly better in the DVD group (p < 0.05). RWMA improvement was more frequent in DVD patients (68% vs. 54%, p = 0.093). Functionally, 90% of DVD patients achieved NYHA Class I/II status compared to 76% in the TVD group. Rehospitalization, postoperative atrial fibrillation, and in-hospital mortality were numerically lower in the DVD group, though not statistically significant. Conclusion: Patients with double vessel disease demonstrated superior early recovery of left ventricular function and more favorable clinical outcomes following OPCABG compared to those with triple vessel disease.