title: Outcome of patients after coronary artery bypass grafting in cardiogenic shock.
abstract: OBJECTIVE
  Coronary artery bypass graft (CABG) surgery in patients with cardiogenic shock (CS) is a rare and very high-risk procedure carrying high mortality. In this study we reviewed hospital outcomes and 1-year survivals in these high-risk patients.
  
  
  METHODS
  During a 4-year period (May 2001 to April 2005), 412 patients were operated on for CABG by a single surgeon, and 13 (3.1%) of them were in CS at the time of procedure.
  
  
  RESULTS
  The 30-day mortality of patients who underwent CABG during CS was 16%, and mean age was 57+/-10 years. A total of 77% were male, 77% were hypertensive, 38% were diabetic, and 31% had renal impairment. Myocardial infarction (MI) affected 62% within 48 h of surgery. Moderate to poor left ventricular function was found in 92%. Twenty-three percent had a preoperative intra-aortic balloon pump. Postinfract ventricular septal defect was present in 16%, and catheter-related problems were present in 23% of patients. After 1 year, all patients (11) were alive, and 85% of them were in New York Heart Association (NYHA) classes I to II.
  
  
  CONCLUSIONS
  CABG in CS produces significant 1-year survival benefits and improvements in functional class. Therefore, early surgical intervention is suggested where percutaneous coronary intervention is not possible or contraindicated for anatomical reasons.
authors: Department of Cardiothoracic Surgery, Liaquat National Hospital, Karachi, Pakistan.
authors: Mudassir Iqbal
authors: MI
authors: Dar
authors: Atta Ul
authors: AU
authors: Manan
authors: Binish
authors: B
authors: Rasheed
authors: Ghulam
authors: G
authors: Murtaza
authors: Mansoor
authors: M
authors: Ahmad
mesh_terms: D001026:Coronary Artery Bypass / Q000009:adverse effects; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality / Q000601:surgery*; D011183:Postoperative Complications; D012770:Shock, Cardiogenic / Q000150:complications* / Q000401:mortality; D015996:Survival Rate; D016896:Treatment Outcome