Outcomes of Cardiac Surgery in Patients with Heart Failure

Abstract

Chronic congestive heart failure with reduced ejection fraction (EF) significantly affects survival and hospitalization rates. This multicenter study analyzed the results of cardiac surgery in patients with heart failure. We used retrospective and prospective analyses and analyzed data from 199 patients with heart failure and EF < 50% who underwent various types of cardiac surgeries, including valve surgery, aortic surgery, and coronary artery bypass grafting. Outcome measures were postoperative heart function and survival rates. The in-hospital mortality rate was 1.0%, while the 2-year cardiac death rate was 8.5%. The freedom from cardiac death rates at 6, 12, and 24 months postoperatively were 97.0%, 94.5%, and 91.5%, respectively. The freedom from readmission from heart failure rates after 6, 12, and 24 months postoperatively were 97.0%, 93.5%, and 88.4%, respectively. In risk factor analysis for mortality at 24 months postoperatively, age (odds ratio [OR], 1.241; 95% confidence interval [CI], 1.083–3.155; p = 0.03), chronic kidney disease with renal replacement therapy (OR, 3.154; 95% CI, 1.333–7.158; p = 0.03), and preoperative lower EF (OR, 0.884; 95% CI, 0.429–0.919; p = 0.04) were significant risk factors. Analysis using linear mixed models demonstrated significant improvements in cardiac hemodynamics and New York Heart Association class postoperatively. In conclusion, cardiac surgery in patients with heart failure showed favorable outcomes with marked improvements in heart function and symptoms.