[Indications for emergency cardiovascular surgery at the Institute of Cardiology]

Between 1981 and 1989 73 patients (46 males, 27 females aged 15-69; mean 42) underwent emergency cardiac operation in the I Clinic of Cardiosurgery. There were 39 (53%) patients with valvular disease, 18 (25%) with prosthetic valve dysfunction and endocarditis, 9 (12%) with acute aortic dissection (2 of them had Marfan's syndrome), 5 (7%) with atrial myxoma and 2 (3%) with malignant pericardial mesothelioma. All of them were treated in C.C.U. before surgery. 27 urgent operations were performed within the first 24 hours after the admission to C.C.U. 30 of 73 patients died (41%). The IV NYHA functional class was stated as the most significant predictive factor for in-hospital mortality. The greatest mortality was observed in the group of patients with valvular disease (53%). In hospital survival rate reached 50% after reoperations as a procedure of choice in prosthetic valve dysfunction. Good early results were observed in patients with aortic dissection (survival rate--66%). The presence of Marfan's syndrome was associated with a poor surgical prognosis. There were no deaths after atrial myxoma removal, but all patients with malignant mesothelioma died. The most common cause of all deaths was congestive heart failure.