RESUMEN
BACKGROUND: The prevalence of patients with severe left ventricular dysfunction (LVD) referred for coronary artery bypass grafting (CABG) is increasing. Preoperative LVD is an established risk factor for early and late mortality after revascularization. The aim of the present study was to assess the early outcome of patients with severe LVD undergoing CABG. METHODS: Between December 2012 and November 2014, 145 consecutive patients with severely impaired LV function (ejection fraction ≤ 30%) undergoing either on-pump or off-pump CABG were enrolled. The primary end point was all-cause mortality. Different variables (preoperative, intraoperative, and postoperative) were evaluated and compared. RESULTS: The mean age of the patients was 58.7 years (range, 34 to 87 years), and 82.8% of the patients were male. The mean preoperative LV ejection fraction was 25.33 ± 5.07% (10 to 30%), which improved to 26.67 ± 5.38% (10 to 40%) (p value < 0.001). An average of 3.85 coronary bypass grafts per patient was performed. Significant improvement in mitral regurgitation was also observed after CABG (p value < 0.001). Moreover, 120 patients underwent conventional CABG (82.8%) and 25 patients had off-pump CABG (17.2%). In-hospital mortality was 2.1% (3 patients). Patients who underwent off-pump CABG had higher operative mortality than did those undergoing conventional CABG despite a lower severity of coronary involvement and a significantly lower number of grafts (p value < 0.050). Conversely, morbidity was significantly higher in conventional CABG (p value < 0.050). CONCLUSION: CABG in patients with severe LVD can be performed with low mortality. CABG can be considered a safe and effective therapy for patients with a low ejection fraction who have ischemic heart disease and predominance of tissue viability.
RESUMEN
Methanol poisoning continues to be a serious problem in Iran; however, there is not yet any report of the prevalence of methanol intoxication. This report is a descriptive study of methanol intoxication in Iran. We performed a cross-sectional analysis of 51 patients with methanol intoxication who were admitted to Noor Hospital affiliated with Isfahan University of Medical Science (Isfahan, Iran) from January 2000 to December 2009. Characteristics of the participants, including age, sex, amount of methanol ingestion, exposure type, time from ingestion to presentation, and patient outcome, were recorded. There were 51 patients (84.3% male and 15.7% female; mean age: 32.5 ± 15.2 and 20.1 ± 7.5 years, respectively). Of the patients, 13.7% were under 20 years in age, 51% were from 20 to 29, 11.8% were from 30 to 39, and 23.5% were above 40. Four patients died, 15 survived with late complications, and 32 survived without any complications. There are a growing number of patients presenting with acute poisonings in Iran. Early diagnosis and treatment is necessary to prevent long-term complications.