Coronary artery bypass grafting in patients with heart failure with preserved ejection fraction

Introduction. Objective. To assess the intraoperative and postoperative course in patients with heart failure with preserved ejection fraction (HFpEF) undergoing coronary artery bypass grafting (CABG), and to compare their outcomes with those of patients with reduced ejection fraction (HFrEF) and patients without signs of heart failure (HF). Materials and methods. A total of 154 patients with coronary artery disease were included in the study and divided into three groups: HFpEF (n = 62), HFrEF (n = 54), and no HF (n = 38). All patients underwent isolated CABG with the use of cardiopulmonary bypass. Intraoperative parameters, incidence of rhythm disturbances, and early postoperative outcomes were analyzed. Results. Patients with HFpEF had a higher incidence of postoperative atrial fibrillation (35,5 % vs. 15,8 % in patients without HF; p = 0,040), longer duration of mechanical ventilation (6,5 [5,1–8,0] h vs. 5,5 [4,0–6,5] h; p = 0,003), and longer hospital stay (11 [8,25–15] days vs. 9 [8–10,75] days; p = 0,013). There was also a trend toward a lower rate of spontaneous rhythm recovery after reperfusion in the HFpEF group. Conclusions. HFpEF significantly affects the postoperative course in patients undergoing CABG. The increased risk of complications and prolonged recovery period highlight the need for an individualized approach to managing this patient population.