Outcomes of Coronary Artery Bypass Grafting in Patients With Impaired Left Ventricular Function and the Role of Preoperative Myocardial Viability

Abstract

Background Coronary artery bypass grafting (CABG) improves outcomes in patients with ischemic left ventricular (LV) dysfunction, but accurate patient selection remains critical. Late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) imaging aids in assessing myocardial viability, a key predictor of surgical outcomes. This study aimed to evaluate the impact of myocardial viability on postoperative outcomes in patients undergoing CABG. Methods This was a single-center prospective analysis of clinical outcomes in 37 patients with impaired LV function (mean ejection fraction: 35.59%); myocardial viability was assessed using LGE-CMR prior to CABG. Patient demographics, perioperative details, and short-term outcomes, including in-hospital mortality and recovery metrics, were analyzed. Results Patients exhibited high myocardial viability (mean: 88.16%), with an average of 2.35 non-viable segments. In-hospital mortality was 5.4% (n=2), and the mean hospital stay was six days. Patients with greater viability demonstrated better recovery and fewer complications. Multivessel coronary artery disease was prevalent (94.6%, n=35), with tailored graft configurations addressing individual anatomical and disease complexities. Conclusion LGE-CMR is a valuable tool for predicting outcomes in ischemic LV dysfunction. Myocardial viability strongly correlates with improved surgical recovery, highlighting the importance of integrating LGE-CMR into preoperative decision-making. Further studies are required to explore the long-term impact of myocardial viability on treatment outcomes and quality of life.

Keywords: cardiac magnetic resonance (cmr) imaging; coronary artery bypass grafting (cabg); echocardiography; ischemic left ventricular dysfunction; late gadolinium enhancement (lge); myocardial viability.