title: Off-pump coronary artery bypass for emergency myocardial revascularization.
abstract: Emergency coronary artery bypass is associated with increased operative mortality. The objective of this study was to evaluate the efficiency and safety of off-pump emergency coronary artery bypass, and to compare the outcome with that of the conventional on-pump procedure. Data of 79 patients who underwent emergency isolated coronary artery bypass were reviewed retrospectively; 45 had off-pump coronary bypass and 34 had conventional surgery. In the off-pump group, mean ejection fraction was significantly lower (28% +/- 9% vs. 39% +/- 10%), and there were fewer grafts per patient (1.8 +/- 0.7 vs. 3.2 +/- 0.8). Early mortality was higher in the conventional surgery group (14.7% vs. 8.9%), but late mortality was similar in both groups. Patients who had on-pump surgery had lower rates of recurrent angina (16% vs. 34%) and symptoms of heart failure (20% vs. 51%). Re-hospitalization was more common in off-pump patients, but cardiac re-interventions were similar. There was no significant difference in 5-year survival rates. The results of off-pump coronary bypass were better than the preoperative predicted EuroSCORE, thus it was concluded that patients treated on an emergency basis should have an off-pump revascularization procedure.
authors: Department of Cardiac Surgery, Makassed Hospital, Jerusalem, PO Box 19482, Israel. darwaz30@hotmail.com
authors: Ahmad K
authors: AK
authors: Darwazah
authors: Raed A H Abu
authors: RA
authors: Sham'a
authors: Ismail
authors: I
authors: Isleem
authors: Basel
authors: B
authors: Hanbali
authors: Bashar
authors: B
authors: Jaber
mesh_terms: D000328:Adult; D000787:Angina Pectoris / Q000209:etiology; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects / Q000401:mortality; D023921:Coronary Stenosis / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D004638:Emergency Treatment; D005260:Female; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome