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Vessel Plus 2018;2:31 I http://dx.doi.org/10.20517/2574-1209.2018.58 Page 3 of 4

Results: The analysis of thrombolytic group is as follows: incidence of death was 2% per patient-year, free-
dom from Peripheral embolism 97.3% ± 1.8%, freedom from CNS bleeding 98.2% ± 3.8%, freedom from
stroke 97.2% ± 2.6%,freedom from TIA 98.1% ± 2.8%, freedom from Coronary embolism 100%, freedom from
major bleeding with transfusion 96.3% ± 4.8%, freedom from thrombolytic failure 95.4% ± 3.7%. The peak
and mean gradient was 11.5 ± 4.8, 5.2 ± 3.56 at the end of completed thrombolysis. The analysis of re-oper-
ative group are as follows: incidence of death was 3% per patient-year , freedom from Peripheral embolism
98.3% ± 4.8%, freedom from CNS bleeding 99.2% ± 2.8%, freedom from stroke 95.2% ± 3.5%, freedom from
TIA 100%, freedom from Coronary embolism 100%, freedom from major bleeding with transfusion 94.3% ±
5.4%. The peak and mean gradient was 9.5 ± 4.8, 4.2 ± 3.56 at the end of re-operation on the 7th post-op day,
10.5 ± 4.8, 4.2 ± 1.56 at the end of first year and 11.5 ± 4.8, 5.2 ± 3.75, at the end of third year respectively.

Conclusion: Re-preoperation and thrombolysis are the widely accepted options for treatment of mechanical
heart valve thrombosis and both seem to be equally effective. The percentage of embolic events and recur-
rent thrombosis are higher in thrombolysis group while we had almost comparable mortality in both the
groups. Longer follow-up with a large group of patients is necessary for further results.

4. Outcome of coronary artery bypass grafting surgery in patients with low ejection fraction

Mohammed Aslam Hossain, Mayank Acharya, Dharmendra Joshi, Niraj Bhattarai, Satish Vaidya,
Karan Rai, Sanaul Sarker, Samir Azam Sunny

Department of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka 1000, Ban-
gladesh.

Aim: To analyze the outcome of coronary artery bypass grafting surgery in patients with low ejection frac-
tion. Coronary artery bypass surgery is one of the most frequently performed among various surgeries.
In recent years the mortality and morbidity related to the procedure has decreased even in the developing
world. However a significant peri surgical morbimortality burden remains among patients with heart failure
patients. The factors of this may be due to problems in wound healing, pulmonary complications, post per-
fusion syndrome, poor tissue oxygenation, acute liver and kidney injuries, prolonged ventilation, frequent
cerebrovascular events, presence of other comorbid conditions, all of which affect the patient more than
compared to a similar patient with moderate or normal preoperative ejection fraction.

Methods: Data were obtained and analyzed from 102 patients who underwent coronary artery bypass graft-
ing surgery having a preoperative left ventricular ejection fraction ≤ 40%. A subgroup of patients with EF ≤
30% (n = 28) were also analyzed separately.

Results: The mean age of our patient was 57.9 ± 7.5 years of which 85 (83.3%) were males and 17 (16.7%) were
females. 74 (72.5%) patients had LVEF 31-40 and 28 (27.5%) had ≤ 30. Comparison of pre-operative LVEF and
post-operative LVEF at 1 and 3 months revealed mean LVEF 33.15 against 37.63 (P ≤ 0.001) at 1 month and
33.09 against 38.04 (P ≤ 0.001) at 3 months. Other per- and post-operative outcome variables were also ana-
lyzed like arrhythmia, inotrope support time, bypass requirement, pulmonary complications, mechanical
ventilation time, death and other variables.

Conclusion: Operations on patients with low ejection fraction warrant additional vigilance, albeit with prop-
er precaution the outcome is favorable.