Coronary artery bypass grafting within 30 days of an acute myocardial infarction.
Early surgical intervention is now often considered for symptomatic patients after an acute myocardial infarction. Conversely coronary artery bypass grafting soon after an acute myocardial infarction poses substantial risks. The present study was performed to evaluate the results of Coronary artery bypass grafting soon after an acute myocardial infarction.


METHODS
From November 1991 to November 1999, 478 consecutive patients underwent coronary artery bypass grafting and 68 of these underwent an operation within 30 days of AMI. The data of these patients were analyzed retrospectively. Univariate and multivariate analyses of many variables were performed regarding operative mortality.


RESULTS
Operative mortality (7.4%) was significantly higher in the patients with an acute myocardial infarction than in the patients without it (0.8%) during the same period as the subjects of this study. Coronary artery bypass grafting without arterial grafts was solely determined to be the predictor of survival. The survival curve demonstrated better long-term results in patients undergoing bypass grafting with arterial grafts than in patients undergoing bypass grafting with venous grafts alone.


CONCLUSIONS
If hemodynamic conditions can not be stabilized, then coronary artery bypass grafting using arterial grafts, when indicated, should be performed even early after AMI.
Hirotani
T
T
Department of Cardiovascular Surgery, Tokyo Saiseikai Central Hospital, 1-7-14 Mita, Minato-ku, Tokyo 108-0073, Japan.
Kameda
T
T
Shirota
S
S
Nakao
Y
Y
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality* / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D013997:Time Factors