title: Emergency coronary artery bypass grafting for left main shock syndrome.
abstract: OBJECTIVE
  Acute myocardial infarction (AMI) complicated by cardiogenic shock and left main coronary artery disease (left main shock syndrome) shows high morbidity, and whether early coronary artery bypass grafting (CABG) improves the clinical outcome remains unclear.
  
  
  METHODS
  Six consecutive patients (mean age, 61.6 years) with MI complicated by left main shock syndrome underwent emergency CABG. Patients were divided into 2 groups according to the time from MI to reperfusion; within 8 hours in 3 patients and beyond 8 hours in the remaining. Average postoperative peak creatinine kinase (CK) and creatinine kinasemyosin band (CK-MB) levels were recorded, and the ejection fraction (EF) was measured with ultrasound cardiography.
  
  
  RESULTS
  Significant differences in postoperative EF and CPK-MB were observed between the 2 groups. The 30-day survival rate was 100%. Five patients left the hospital alive, while 1 died on postoperative day 78.
  
  
  CONCLUSIONS
  AMI complicated by cardiogenic shock and left main coronary artery disease can be effectively treated with emergency CABG, with acceptable mortality and morbidity. Emergency CABG for MIs within 8 hours can improve survival in patients with left main shock syndrome.
authors: Department Cardiovascular Surgery, Aizawa Hospital, Matsumoto, Nagano, Japan. oohajime@peach.ocn.ne.jp
authors: Hajime
authors: H
authors: Osawa
authors: Toshihiro
authors: T
authors: Fujimatsu
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality; D003324:Coronary Artery Disease / Q000097:blood / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D052279:Creatine Kinase, MB Form / Q000097:blood; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D012770:Shock, Cardiogenic / Q000097:blood / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D013318:Stroke Volume; D013577:Syndrome; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D052279:Creatine Kinase, MB Form