Emergency coronary artery bypass grafting after acute myocardial infarction. What influences early postoperative mortality?

Although short- and long-term outcomes after elective coronary artery bypass grafting (CABG) has improved, emergency CABG after acute myocardial infarction (AMI) does not always bring satisfactory prognosis. In this report, early postoperative and follow-up results were studied. Furthermore, variables related to hospital mortality were explored. From among 186 patients who underwent CABG, 18 patients formed the basis of this research. This series included 16 males and 2 females, with a mean age of 65.3 years old. Hospital mortality of the patients was 38.9%, and actual survival rate of all the patients 5 years after CABG was 55.6%. Factors that predicted hospital mortality in those patients included increased age and preoperative cardiogenic shock. There was no difference in hospital mortality between the patients operated on with only saphenous vein (SV) and those operated on in combination with SV and internal thoracic artery (ITA). In emergency CABG, cardiogenic shock before surgery was most likely to influence hospital mortality. Therefore, an appropriate circulatory support system should be applied to improve hemodynamic status before bypass surgery.