Urgent Coronary Angiography Following Cardiac Surgery: Insights from a High-Volume Cardiac Surgery Center

Post-operative myocardial infarction is a possible complication following cardiac surgery. Data on the incidence, predictors and prognosis of urgent coronary angiography (UCA) after cardiac surgery are scarce.

This study aims to report in hospital and 1-year follow-up outcomes of a recent large cohort of patients undergoing UCA after cardiac surgery.

This study provides a retrospective analysis of an high volume cardiac center (Maria Cecilia Hospital, Italy), from 2016 to 2021 regarding patients treated with coronary artery bypass grafting (CABG), valve, or aortic root surgery, focusing on those who required UCA within the same hospitalization.

Out of 6505 cardiac surgeries, 119 patients (1.83%) underwent UCA, with a median age of 69 years. The study found that UCA was more frequent post-CABG (2.62%) than non-CABG interventions (1.35%, p < 0.001). A graft failure was detected in 31.1% of the cases, while a native vessel complication in 36.1%. The leading reasons for UCA included ST/T abnormalities, ventricular arrhythmias, and hemodynamic instability, with 92% of UCAs performed within a week post-surgery. The in-hospital mortality rate was 32%, with no significant difference between CABG and non-CABG patients. Predictive factors for in-hospital mortality included Euroscore II, hemodynamic instability and late UCA. One-year follow-up showed a low mortality rate (2.5%) among discharged patients.

UCA resulted to have a pivotal role in detecting coronary complications after cardiac surgery, guiding subsequent treatment decisions. Despite the high in-hospital mortality rate, survival showed an overall low mortality at the 1-year mark.