Surgical revascularization for acute coronary syndrome
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Objective: The purpose of this study was to evaluate the adequate timing of coronary artery bypass grafting (CABG) for acute coronary syndrome (ACS). Methods: In our institution, emergency CABG has been avoided when possible for ACS patients favoring stabilization with medical therapies, including intra-aortic balloon pumping or percutaneous coronary intervention. After thorough preoperative examinations, an urgent CABG is performed. A total of 67 patients with ACS underwent CABG, comprised of 33 patients receiving an emergency CABG (emergent group: E-G) and 34 patients receiving an urgent CABG (urgent group: U-G). The early and long-term results were evaluated retrospectively. Results: Preoperatively, the incidences of acute myocardial infarction and cardiogenic shock were significantly higher in E-G. No significant differences were found in the intraoperative factors except for the number of distal anastomoses (2.5 in E-G vs. 3.1 in U-G, p=0.01). The hospital mortality was 9.1% in E-G, and 2.9% in U-G, with no significant difference between the groups. Moreover, no patient in U-G necessitated emergency CABG while waiting for surgery. The patency rate of the grafts was 100% in E-G, and 96.2% in U-G. The 5-year survival rate excluding in-hospital death was 80.3% in E-G, and 78% in U-G (p>0.05). The 5-year cardiac event-free rate was 80.3% in E-G, and 80.9% in U-G (p>0.05). Conclusion: An emergency CABG can be reserved for ACS patients when symptoms and hemodynamic state are stabilized with medical therapies. Improvements in long-term results can be expected after high quality and complete surgical revascularization.
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- Surgical revascularization for acute coronary syndrome
The Japanese Journal of Thoracic and Cardiovascular Surgery
Volume 54, Issue 3 , pp 95-102
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- acute coronary syndrome
- emergency coronary artery bypass grafting
- urgent coronary artery bypass grafting
- Industry Sectors
- Author Affiliations
- 1. Department of Cardiovascular Surgery, Tenjin-kai Shin-Koga Hospital, 120 Tenjin-cho, 830-0033, Kurume, Fukuoka, Japan
- 2. Department of Thoracic and Cardiovascular Surgery, Saga Medical School, Saga, Japan