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[Emergency coronary artery bypass grafting with integrated myocardial protection]
K Yoshimoto1, F Okamoto, M Miyata
1Cardiovascular Surgery, Teine-Keijinkai Hospital, Sapporo, Japan.
Insights
Emergency coronary artery bypass grafting (CABG) using integrated myocardial protection showed a 12.7% early mortality rate. Cardiogenic shock and mechanical complications significantly increased mortality risk in these urgent cardiac surgeries.
Area of Science:
- Cardiac Surgery
- Cardiology
- Myocardial Protection
Context:
- Retrospective review of 63 patients undergoing emergency coronary artery bypass grafting (CABG).
- Procedures performed between April 1994 and October 1998.
- Focus on integrated myocardial protection including warm cardioplegic induction.
Purpose:
- To evaluate the early postoperative results of emergency CABG with integrated myocardial protection.
- To identify risk factors associated with early postoperative death.
Summary:
- Emergency CABG patients (n=63) had a mean age of 69.9 years, with 52 experiencing acute myocardial infarction (AMI).
- Preoperative interventions included PTCA (n=20) and IABP (n=53).
- Significant risk factors for mortality included cardiogenic shock, mechanical complications of AMI, prior PTCA, and prolonged cardiopulmonary bypass (CPB) time, resulting in an 8-patient (12.7%) early postoperative death rate.
Impact:
- Highlights the mortality associated with emergency CABG in high-risk patients.
- Identifies critical factors influencing outcomes in urgent cardiac surgery.
- Informs strategies for managing patients with acute coronary syndromes requiring immediate surgical intervention.
Abstract:
In the following retrospective study we reviewed the early postoperative results of emergency CABG; the myocardial management was achieved by utilization of integrated myocardial protection including warm cardioplegic induction, performed at our hospital. From April 1st 1994 to October 30th 1998; 63 patients underwent emergency CABG with integrated myocardial protection. All surgical procedures were performed within 6 hours from the onset of disease or admission transferred from another hospitals. Age ranged 48 to 86 years (mean 69.9 +/- 8.5; 41 male, 22 female). AMI was present in 52, UAP in 11. Preoperative PTCA was done in 20 and IABP was inserted in 53. Cardiogenic shock in 26, mechanical complications in 6, three vessel disease in 48 and LMT disease in 17 was present. Eight patients (12.7%) died in the early postoperative period. Among evaluated risk factors for early postoperative death; the occurrence of cardiogenic shock, mechanical complications of AMI, preoperatively done PTCA and prolonged CPB time were significantly increasing the mortality rate in early postoperative death.