Turk Kardiyol Dern Ars. 2006; 34(8): 489-493
Early postoperative results of emergency coronary bypass surgery in patients presenting within six hours of acute myocardial infarction
Mustafa Bilge Erdoğan1
, Feragat Uygur1
, Bülent Meşe1
, Alper Serçelik2
, Cemil Cahit Öğütmen1
, Birol Yamak1
, Bülent Kısacıkoğlu11
Sanko Hospital Department Of Cardiovascular Surgery, Gaziantep, Turkey2
Sanko Hospital Department Of Cardiology, Gaziantep, Turkey
OBJECTIVES We evaluated early postoperative results of coronary bypass operations in patients presenting within the first six hours of acute myocardial infarction (AMI).
STUDY DESIGN A total of 128 patients (97 men, 31 women; mean age 61±5 years; range 41 to 78 years) underwent coronary bypass grafting within the first six hours of AMI. Indications for surgery were detection of critical multivessel disease on coronary angiography in 88 patients (68.8%), unsuccessful percutaneous transluminal coronary angioplasty (PTCA) in 20 patients (15.6%), and development of complications following elective primary PTCA in 20 patients. Six patients (4.7%) required cardiopulmonary resuscitation due to cardiac arrest at angiography. Surgery was undertaken by cardiopulmonary bypass in 104 patients (81.3%), and on the beating heart in 24 patients (18.8%). Intra-aortic balloon pump was applied to eight patients preoperatively, and to six patients postoperatively.
RESULTS Mortality occurred in six patients (4.7%), three of whom received cardiopulmonary resuscitation. One patient and two patients died in the late postoperative period from sepsis and neurologic complications, respectively. After operation, positive inotropic support was required in 32 patients. Postoperative complications were severe ventricular arrhythmias (n=18), atrial fibrillation (n=4), and wound site infection (n=5). Four patients underwent revision due to hemorrhage. The mean intensive care unit stay was 3.7±1.9 days, and the mean hospitalization was 12.6±6.7 days.
CONCLUSION Coronary bypass operations are relatively safe with acceptable mortality and morbidity rates in patients requiring surgical treatment within the first six hours of AMI.
Coronary angiography, coronary artery bypass, myocardial infarction/surgery; myocardial revascularization; shock, cardiogenic
How to cite this article
Mustafa Bilge Erdoğan, Feragat Uygur, Bülent Meşe, Alper Serçelik, Cemil Cahit Öğütmen, Birol Yamak, Bülent Kısacıkoğlu. Early postoperative results of emergency coronary bypass surgery in patients presenting within six hours of acute myocardial infarction. Turk Kardiyol Dern Ars. 2006; 34(8): 489-493
Corresponding Author: Mustafa Bilge Erdoğan, Türkiye