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Emergency operation after failed angioplasty

V Parsonnet1, D Fisch, I Gielchinsky

  • 1Department of Thoracic and Cardiovascular Surgery, Newark Beth Israel Medical Center, N.J. 07112.

The Journal of Thoracic and Cardiovascular Surgery
|August 1, 1988
PubMed

Insights

Emergency coronary bypass after failed angioplasty has significantly higher mortality and complication rates compared to elective procedures. This emergency surgery is not equivalent to planned coronary bypass grafting due to increased risks.

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology

Background:

  • Failed angioplasty often necessitates urgent surgical intervention.
  • Elective coronary bypass grafting is a standard treatment for coronary artery disease.

Purpose of the Study:

  • To compare the outcomes of emergency coronary bypass grafting after failed angioplasty with historically matched elective coronary bypass grafting patients.

Main Methods:

  • Retrospective comparison of two patient groups: emergency bypass post-failed angioplasty versus elective bypass.
  • Groups were matched for age, sex, ejection fraction, NYHA classification, diabetes, and hypertension.

Main Results:

  • Emergency bypass showed higher mortality (12% vs 1.5%), hemorrhage (28% vs 13%), cardiac tamponade (10.5% vs 1.5%), myocardial infarction (28% vs 9%), and longer hospital stay (15.3 vs 13.4 days).
  • Cardiogenic shock was associated with a very poor prognosis, with 4 out of 5 patients dying.

Conclusions:

  • Emergency coronary bypass after failed angioplasty is associated with significantly increased postoperative morbidity and mortality.
  • The risks associated with emergency bypass render it non-equivalent to elective coronary bypass grafting.

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