Surgical management for acute coronary insufficiency with three year's follow-up

Area of Science:

• Cardiology
• Cardiac Surgery
• Vascular Surgery

Background:

• Acute coronary insufficiency, defined as unstable angina with ECG changes, presents a critical cardiac event.
• Prompt intervention is crucial for patients experiencing severe coronary insufficiency.
• Saphenous vein grafting is a common surgical revascularization technique.

Purpose of the Study:

• To evaluate the efficacy and safety of early coronary artery bypass grafting (CABG) using saphenous vein grafts in patients with acute coronary insufficiency.
• To assess the long-term outcomes, including mortality and myocardial infarction rates, following this intervention.

Main Methods:

• Forty-five consecutive patients diagnosed with acute coronary insufficiency underwent saphenous vein CABG within 48 hours of symptom onset.
• Patients were monitored for a 3-year follow-up period.
• Outcomes assessed included operative mortality, long-term mortality, and myocardial infarction events.

Main Results:

• The operative mortality rate was 8.8%.
• The 3-year cumulative mortality rate was 11%, with one late death due to myocardial infarction.
• The 3-year myocardial infarction rate was 4%, with one nonfatal event occurring early postoperatively.
• The majority of surviving patients (38/40) were in Class I clinical status at follow-up.

Conclusions:

• Early coronary artery bypass grafting with saphenous vein grafts is a safe and effective treatment for acute coronary insufficiency.
• This surgical approach leads to favorable long-term clinical outcomes and a low incidence of major adverse cardiac events.
• Urgent surgical revascularization should be considered for patients with unstable angina and ECG abnormalities.