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[Emergency myocardial revascularization of the beating heart after angioplasty failure]

M Ferrari1, E Onorato, G Ferrari

  • 1Divisione di Cardiochirurgia, Clinica S. Rocco di Franciacorta, Ome, BS.

Giornale Italiano Di Cardiologia
|May 18, 1999
PubMed

Insights

Emergency coronary artery bypass grafting on a beating heart offers a life-saving solution for patients experiencing failed angioplasty. This technique avoids extracorporeal circulation, improving outcomes in high-mortality left anterior descending artery occlusions.

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology

Background:

  • Left anterior descending coronary artery occlusion during angioplasty carries a high mortality risk, even with emergent revascularization.
  • Failed angioplasty necessitates rapid and effective intervention to prevent myocardial damage and improve survival.

Observation:

  • This report details two critical cases where patients underwent emergency coronary artery bypass grafting (CABG).
  • The procedures were performed on a beating heart, specifically excluding the use of extracorporeal circulation (heart-lung machine).

Findings:

  • Beating heart CABG without extracorporeal circulation was successfully employed as an emergency measure following failed angioplasty.
  • This approach provided a viable alternative for revascularization in complex, high-risk scenarios.

Implications:

  • Off-pump coronary artery bypass grafting (OPCAB) can be a safe and effective emergency strategy in selected cases of failed percutaneous coronary intervention.
  • This case series highlights the potential for OPCAB to reduce mortality and morbidity in acute coronary occlusions unresponsive to standard angioplasty techniques.

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