title: Results of treatment methods in cardiac arrest following coronary artery bypass grafting.
abstract: OBJECTIVE
  Emergency re-revascularization and invasive/noninvasive interventions in intensive care unit (ICU) are two main treatment methods in cardiac arrest following coronary artery bypass grafting (CABG). We evaluated the short- and long-term consequences of these two methods and discussed the indications for re-revascularization.
  
  
  METHODS
  Between 1998 and 2004, a total of 148 CABG patients, who were complicated with cardiac arrest, were treated with emergency re-revascularization (n = 36, group R) and ICU procedures (n = 112, group ICU). Re-revascularizations are mostly blind operations depending on clinical/hemodynamic criteria. These are: no response to resuscitation, recurrent tachycardia/fibrillation, and severe hemodynamic instability after resuscitation. Re-angiography could only be performed in 3.3% of the patients. Event-free survival of the groups was calculated by the Kaplan-Meier method. Events are: death, recurrent angina, myocardial infarction, functional capacity, and reintervention.
  
  
  RESULTS
  Seventy percent of patients, who were complicated with cardiac arrest, had perioperative myocardial infarction (PMI). This rate was significantly higher in group R (p = 0.013). The major finding in group R was graft occlusion (91.6%). During in-hospital period, no difference was observed in mortality rates between the two groups. However, hemodynamic stabilization time (p = 0.012), duration of hospitalization (p = 0.00006), and mechanical support use (p = 0.003) significantly decreased by re-revascularization. During the mean 37.1 +/- 25.1 months of follow-up period, long-term mortality (p = 0.03) and event-free survival (p = 0.029) rates were significantly in favor of group R.
  
  
  CONCLUSIONS
  Better short- and long-term results were observed in the re-revascularization group.
authors.affiliation: Department of Cardiovascular Surgery, Siyami Ersek Thoracic and Cardiovascular Surgery Centre, Istanbul, Turkey.
authors.forename: Mehmet R
authors.initials: MR
authors.lastname: Guney
authors.forename: Bulend
authors.initials: B
authors.lastname: Ketenci
authors.forename: Fikri
authors.initials: F
authors.lastname: Yapici
authors.forename: Onur
authors.initials: O
authors.lastname: Sokullu
authors.forename: Mehmet F
authors.initials: MF
authors.lastname: Firat
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Uyarel
authors.forename: Nihan
authors.initials: N
authors.lastname: Yapici
authors.forename: Bayer
authors.initials: B
authors.lastname: Cinar
authors.forename: Murat
authors.initials: M
authors.lastname: Demirtas
mesh_terms: D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003325:Coronary Care Units; D005260:Female; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D017202:Myocardial Ischemia / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology