[Surgical results of emergency coronary artery bypass grafting: effect of left main trunk lesion].
Emergency coronary artery bypass grafting has higher risk than elective surgery. Furthermore, if a lesion is located at left main coronary artery, the frequency of cardiogenic shock or high risk patient would be greater, and operative results would be worse. Between January, 1989 and December, 1995, 45 patients who underwent emergency CABG were included. Age ranged 44 to 80 years (mean 67 +/- 7.6 years; 31 men, 14 women). Of 45 cases, 12 cases were patients with LMT lesion. Results were analysed by univariate analysis and multivariate logistic analysis. Of 45 emergency cases, 5 were operative death and 3 were hospital death. Mortality rate was 17.8%, which was significantly higher than the mortality of elective CABG (2.8%) during the same period (p < 0.001). A factor that influenced the mortality was acute myocardial infarction (AMI), which was confirmed by both univariate and multivariate logistic analyses. Odds ratio (relative risk) was 12.4 for AMI. Only one patient died in 12 cases with LMT (8.3%). This case was due to complication after catheter intervention possibly caused by MOF. Thus, the relative risk of LMT was not so high (p = n.s). Other factors showed no significant correlation. Although the emergency case of LMT lesion was generally severe, we could have the same result as other emergency surgeries when patients were revascularized as soon as possible.
Shiroma
K
K
Department of Cardiovascular Surgery, Toho University School of Medicine, Tokyo, Japan.
Ebine
K
K
Tamura
S
S
Yokomuro
M
M
Suzuki
H
H
Muraoka
M
M
Kamezaki
M
M
Kosakai
K
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000601:surgery; D001026:Coronary Artery Bypass / Q000401:mortality*; D003331:Coronary Vessels / Q000473:pathology*; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000601:surgery; D015996:Survival Rate