Related Experiment Video
Updated: Jun 27, 2026
Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
Published on: March 27, 2018
Results of treatment methods in cardiac arrest following coronary artery bypass grafting
Mehmet R Guney1, Bulend Ketenci, Fikri Yapici
1Department of Cardiovascular Surgery, Siyami Ersek Thoracic and Cardiovascular Surgery Centre, Istanbul, Turkey.
Insights
Emergency re-revascularization after coronary artery bypass grafting (CABG) improved outcomes for cardiac arrest patients. This cardiac surgery intervention led to better short- and long-term survival rates compared to intensive care unit (ICU) procedures.
Area of Science:
- Cardiovascular Surgery
- Critical Care Medicine
- Cardiac Surgery Outcomes
Background:
- Cardiac arrest following coronary artery bypass grafting (CABG) presents significant management challenges.
- Two primary treatment strategies include emergency re-revascularization and intensive care unit (ICU) interventions.
- Evaluating the comparative effectiveness of these approaches is crucial for patient management.
Purpose of the Study:
- To compare the short- and long-term consequences of emergency re-revascularization versus ICU interventions in patients experiencing cardiac arrest post-CABG.
- To discuss the clinical indications for emergency re-revascularization in this patient population.
Main Methods:
- A retrospective study of 148 CABG patients with cardiac arrest between 1998 and 2004.
- Patients were divided into emergency re-revascularization (n=36) and ICU procedures (n=112) groups.
- Event-free survival was calculated using the Kaplan-Meier method, with events including death, recurrent angina, myocardial infarction, functional capacity, and reintervention.
Main Results:
- Perioperative myocardial infarction (PMI) occurred in 70% of patients, significantly higher in the re-revascularization group.
- Graft occlusion was the major finding in the re-revascularization group (91.6%).
- While in-hospital mortality showed no difference, re-revascularization significantly reduced hemodynamic stabilization time, hospitalization duration, and mechanical support use. Long-term mortality and event-free survival favored the re-revascularization group.
Conclusions:
- Emergency re-revascularization demonstrates superior short- and long-term outcomes compared to intensive care unit interventions for cardiac arrest post-CABG.
- The findings support the consideration of emergency re-revascularization in select patients experiencing cardiac arrest after coronary artery bypass grafting.
Background And Aim Of The Study:
Emergency re-revascularization and invasive/noninvasive interventions in intensive care unit (ICU) are two main treatment methods in cardiac arrest following coronary artery bypass grafting (CABG). We evaluated the short- and long-term consequences of these two methods and discussed the indications for re-revascularization.
Methods:
Between 1998 and 2004, a total of 148 CABG patients, who were complicated with cardiac arrest, were treated with emergency re-revascularization (n = 36, group R) and ICU procedures (n = 112, group ICU). Re-revascularizations are mostly blind operations depending on clinical/hemodynamic criteria. These are: no response to resuscitation, recurrent tachycardia/fibrillation, and severe hemodynamic instability after resuscitation. Re-angiography could only be performed in 3.3% of the patients. Event-free survival of the groups was calculated by the Kaplan-Meier method. Events are: death, recurrent angina, myocardial infarction, functional capacity, and reintervention.
Results:
Seventy percent of patients, who were complicated with cardiac arrest, had perioperative myocardial infarction (PMI). This rate was significantly higher in group R (p = 0.013). The major finding in group R was graft occlusion (91.6%). During in-hospital period, no difference was observed in mortality rates between the two groups. However, hemodynamic stabilization time (p = 0.012), duration of hospitalization (p = 0.00006), and mechanical support use (p = 0.003) significantly decreased by re-revascularization. During the mean 37.1 +/- 25.1 months of follow-up period, long-term mortality (p = 0.03) and event-free survival (p = 0.029) rates were significantly in favor of group R.
Conclusion:
Better short- and long-term results were observed in the re-revascularization group.
Related Concept Videos
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:25Cardiopulmonary Resuscitation IV: Pharmacological Management
01:27Coronary Artery Disease V: Interprofessional Care
01:21Cardiopulmonary Resuscitation I: Adult