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Bailout bypass surgery for complications of coronary interventions

Marcin P Szczechowicz1,2, Sabreen Mkalaluh1,2, Saeed Torabi1

  • 1Department of Cardiac Surgery, Heart and Marfan Center, University of Heidelberg, Heidelberg, Germany.

Asian Cardiovascular & Thoracic Annals
|April 12, 2020
PubMed

Insights

Emergency bypass surgery following mechanical complications from percutaneous coronary interventions has similar outcomes to other emergency bypass surgeries. This study found no significant difference in long-term survival for patients needing bailout bypass surgery.

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology

Background:

  • Mechanical complications during percutaneous coronary interventions (PCI) may necessitate emergency bypass surgery.
  • Bailout bypass surgery for PCI complications carries a higher surgical risk compared to other indications.
  • Understanding outcomes for these specific cases is crucial for patient management.

Purpose of the Study:

  • To characterize patients undergoing emergency bypass surgery due to mechanical PCI complications.
  • To compare the long-term outcomes of these patients with those undergoing emergency bypass for other reasons.

Main Methods:

  • Analysis of 707 consecutive patients undergoing isolated emergency bypass surgery (2007-2015).
  • Focus on 44 cases necessitated by mechanical PCI complications (dissections, guidewire entrapment, perforations).
  • Comparison of outcomes between subgroups and with patients undergoing emergency bypass for other indications.

Main Results:

  • The median age was 68 years; 81.8% presented in cardiogenic shock.
  • 84.1% had a prior history of percutaneous coronary intervention.
  • Long-term survival was similar across subgroups and comparable to patients with emergency bypass for other indications (p=0.16).

Conclusions:

  • Emergency bypass surgery due to mechanical PCI complications does not appear to confer a higher surgical risk.
  • Short- and long-term outcomes are similar to patients undergoing emergency bypass surgery for other indications.
  • These findings support current management strategies for mechanical PCI complications.
Abstract

Keywords:
CathetersIatrogenic diseasecoronary artery bypasscoronary diseaseemergenciespercutaneous coronary intervention

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