ORIGINAL ARTICLE Gen Thorac Cardiovasc Surg (2012) 60:202–212 DOI 10.1007/s11748-010-0918-y Outcomes and long-term quality of life of patients with severe left ventricular dysfunction who underwent coronary artery bypass surgery Saeed Davoodi, MD · Mehrdad Sheikhvatan, MD Abbasali Karimi, MD · Seyed Hossein Ahmadi, MD Hamidreza Goodarzynejad, MD Mahmood Sheikh Fathollahi, PhD Abstract Purpose. The aim of this study was to identify determi- nants of long-term results after coronary artery bypass surgery (CABG) in group of Iranian patients with sys- tolic left ventricular (LV) dysfunction. Methods. Reduced LV function was defined as an LV ejection fraction of <30%. Using our surgery database, we randomly selected 110 patients with EF < 30% and the same number of patients with EF ≥ 30% for whom demographic and clinical characteristics as well as in- hospital postoperative outcomes were available. Follow- up data were completed for 94 patients with EF < 30% (85.5%) and 101 patients with EF ≥ 30% (91.8%). Long- term results of the operation and the patients’ quality of life were assessed for a mean follow-up period of 29.4 ± 11.0 months. Results. In-hospital mortality and follow-up survival rates had no statistically differences in the low and normal EF groups (2.2% vs. 1.1% and 86.0% vs. 93.6%, respectively). Long-term surgical morbidity occurred in 43.6% of patients with severe LV dysfunction and in 38.6% of normal EF patients; it was considered similar for the two groups. Family history of coronary artery disease, New York Heart Association class IV, and mod- erate mitral insufficiency were the main predictors of Received: 18 May 2010 / Accepted: 15 October 2010 © The Japanese Association for Thoracic Surgery 2012 long-term morbidity. Regarding the quality-of-life assessment, patients with severe LV dysfunction attained significantly lower levels of social activities. Conclusion. Patients with severe LV dysfunction in com- parison with those with normal LV function had similar 3-year survival rates and long-term complications. To improve survival following CABG in patients with severe LV dysfunction, mitral valve repair/replacement at the time of the initial operation should be considered. Key words Coronary artery bypass · Ventricular dysfunction · Survival · Outcome assessment · Quality of life Introduction Patients with evidence of left ventricular (LV) dysfunc- tion are at considerable risk of developing heart failure and its related high mortality and morbidity. A notable percentage of affected patients develop manifestations of congestive heart failure, leading to the need for long- term therapeutic interventions. Some trials have sug- gested that the progression of systolic LV dysfunction following coronary artery bypass surgery (CABG) leads mainly to higher in-hospital and long-term morbidity and mortality, increased use of hospital resources, and worse long-term survival. 1,2 Recent investigations have emphasized that among patients undergoing CABG the 5-year survival of those with LV systolic dysfunction was significantly lower (≤78%) than that for those with normal systolic function (>90%). 1,3,4 Thus, it is clear that LV dysfunction and its severity plays a pivotal role in the outcome of cardiac S. Davoodi (*) · A. Karimi · S.H. Ahmadi Department of Cardiac Surgery, Tehran Heart Center, Tehran University of Medical Sciences, North Kargar Street, Tehran 1411713138, Iran Tel./Fax +98-21-8802-9256 e-mail: Davoodi@Tehranheartcenter.org M. Sheikhvatan · H. Goodarzynejad · M.S. Fathollahi Department of Cardiology, Tehran Heart Center, Tehran Univer- sity of Medical Sciences, Tehran, Iran