There are currently about 125 million patients with coronary artery disease (CAD) worldwide. Ischemic cardiomyopathy (ICM) and heart failure (HF) caused by myocardial infarction (MI) are the leading causes of death and repeated hospitalization. Research on China-HF Registration in China[1]The data show that 49.6% of hospitalized patients with heart failure in China have coronary heart disease (CHD) and 34.4% have MI. Coronary heart disease combined with ICM and HF is a high-risk group that needs special consideration and is difficult to treat. The latest European and American guidelines on HF and coronary revascularization recommend that coronary artery bypass grafting (CABG) should be the first choice for revascularization in CHD patients with reduced left ventricular ejection fraction (LVEF)[2,3,4,5]。 However, compared with patients with normal LVEF, ICM patients often need surgery to manage MI complications, such as ischemic mitral regurgitation (IMR) and ventricular aneurysm, during the same period of CABG, and may need circulatory support during the perioperative period. The risk of surgical death and complications is higher, which poses higher challenges to preoperative decision-making, intraoperative management and postoperative management. A study on surgical registration of acute and chronic heart failure in China[6]The data shows that between 2012 and 2017, there were 13,665 HF surgeries of all types, more than 60% (8,128 cases) of all types of CABG, 48% (6,531 cases) of CABG alone, and 12% (1,597 cases) of CABG combined with valve or other surgeries. The overall in-hospital mortality rate was 4.1%, and the incidence of major postoperative complications was 10.2%.
